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Acute Kidney Injury After Acute Repair of Type A Aortic Dissection

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Harvard

Helgason, D, Helgadottir, S, Ahlsson, A, Gunn, J, Hjortdal, V, Hansson, EC, Jeppsson, A, Mennander, A, Nozohoor, S, Zindovic, I, Olsson, C, Ragnarsson, SO, Sigurdsson, MI, Geirsson, A & Gudbjartsson, T 2021, 'Acute Kidney Injury After Acute Repair of Type A Aortic Dissection', Annals of Thoracic Surgery, vol. 111, no. 4, pp. 1292-1298. https://doi.org/10.1016/j.athoracsur.2020.07.019

APA

Helgason, D., Helgadottir, S., Ahlsson, A., Gunn, J., Hjortdal, V., Hansson, E. C., Jeppsson, A., Mennander, A., Nozohoor, S., Zindovic, I., Olsson, C., Ragnarsson, S. O., Sigurdsson, M. I., Geirsson, A., & Gudbjartsson, T. (2021). Acute Kidney Injury After Acute Repair of Type A Aortic Dissection. Annals of Thoracic Surgery, 111(4), 1292-1298. https://doi.org/10.1016/j.athoracsur.2020.07.019

CBE

Helgason D, Helgadottir S, Ahlsson A, Gunn J, Hjortdal V, Hansson EC, Jeppsson A, Mennander A, Nozohoor S, Zindovic I, Olsson C, Ragnarsson SO, Sigurdsson MI, Geirsson A, Gudbjartsson T. 2021. Acute Kidney Injury After Acute Repair of Type A Aortic Dissection. Annals of Thoracic Surgery. 111(4):1292-1298. https://doi.org/10.1016/j.athoracsur.2020.07.019

MLA

Vancouver

Author

Helgason, Dadi ; Helgadottir, Solveig ; Ahlsson, Anders ; Gunn, Jarmo ; Hjortdal, Vibeke ; Hansson, Emma C ; Jeppsson, Anders ; Mennander, Ari ; Nozohoor, Shahab ; Zindovic, Igor ; Olsson, Christian ; Ragnarsson, Stefan Orri ; Sigurdsson, Martin I ; Geirsson, Arnar ; Gudbjartsson, Tomas. / Acute Kidney Injury After Acute Repair of Type A Aortic Dissection. In: Annals of Thoracic Surgery. 2021 ; Vol. 111, No. 4. pp. 1292-1298.

Bibtex

@article{0a65fb07ae4344799b040fd0594c5300,
title = "Acute Kidney Injury After Acute Repair of Type A Aortic Dissection",
abstract = "BACKGROUND: The aim of this study was to examine the incidence, risk factors, and outcomes of patients with acute kidney injury (AKI) after surgery for acute type A aortic dissection (ATAAD) using the Nordic Consortium for Acute Type A Aortic Dissection registry.METHODS: Patients who underwent ATAAD surgery at 8 Nordic centers from 2005 to 2014 were analyzed for AKI according to the RIFLE criteria. Patients who died intraoperatively, those who had missing baseline or postoperative serum creatinine, and patients on preoperative renal replacement therapy were excluded.RESULTS: AKI occurred in 382 of 941 patients (40.6%), and postoperative dialysis was required for 105 patients (11.0%). Renal malperfusion was present preoperatively in 42 patients (5.1%), of whom 69.0% developed postoperative AKI. In multivariable analysis patient-related predictors of AKI included age (per 10 years; odds ratio [OR], 1.30; 95% confidence interval [CI], 1.15-1.48), body mass index >30 kg/m 2 (OR, 2.16; 95% CI, 1.51-3.09), renal malperfusion (OR, 4.39; 95% CI, 2.23-9.07), and other malperfusion (OR, 2.10; 95% CI, 1.55-2.86). Perioperative predictors were cardiopulmonary bypass time (per 10 minutes; OR, 1.04; 95% CI, 1.02-1.07) and red blood cell transfusion (OR per transfused unit, 1.08; 95% CI, 1.06-1.10). Rates of 30-day mortality were 17.0% in the AKI group compared with 6.6% in the non-AKI group (P < .001). In 30-day survivors AKI was an independent predictor of long-term mortality (hazard ratio, 1.86; 95% CI; 1.24-2.79). CONCLUSIONS: AKI is a common complication after surgery for ATAAD and independently predicts adverse long-term outcome. Of note one-third of patients presenting with renal malperfusion did not develop postoperative AKI, possibly because of restoration of renal blood flow with surgical repair. Mortality risk persists beyond the perioperative period, indicating that close clinical follow-up of these patients is required.",
author = "Dadi Helgason and Solveig Helgadottir and Anders Ahlsson and Jarmo Gunn and Vibeke Hjortdal and Hansson, {Emma C} and Anders Jeppsson and Ari Mennander and Shahab Nozohoor and Igor Zindovic and Christian Olsson and Ragnarsson, {Stefan Orri} and Sigurdsson, {Martin I} and Arnar Geirsson and Tomas Gudbjartsson",
note = "Copyright {\textcopyright} 2021. Published by Elsevier Inc.",
year = "2021",
month = apr,
doi = "10.1016/j.athoracsur.2020.07.019",
language = "English",
volume = "111",
pages = "1292--1298",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier Inc",
number = "4",

}

RIS

TY - JOUR

T1 - Acute Kidney Injury After Acute Repair of Type A Aortic Dissection

AU - Helgason, Dadi

AU - Helgadottir, Solveig

AU - Ahlsson, Anders

AU - Gunn, Jarmo

AU - Hjortdal, Vibeke

AU - Hansson, Emma C

AU - Jeppsson, Anders

AU - Mennander, Ari

AU - Nozohoor, Shahab

AU - Zindovic, Igor

AU - Olsson, Christian

AU - Ragnarsson, Stefan Orri

AU - Sigurdsson, Martin I

AU - Geirsson, Arnar

AU - Gudbjartsson, Tomas

N1 - Copyright © 2021. Published by Elsevier Inc.

PY - 2021/4

Y1 - 2021/4

N2 - BACKGROUND: The aim of this study was to examine the incidence, risk factors, and outcomes of patients with acute kidney injury (AKI) after surgery for acute type A aortic dissection (ATAAD) using the Nordic Consortium for Acute Type A Aortic Dissection registry.METHODS: Patients who underwent ATAAD surgery at 8 Nordic centers from 2005 to 2014 were analyzed for AKI according to the RIFLE criteria. Patients who died intraoperatively, those who had missing baseline or postoperative serum creatinine, and patients on preoperative renal replacement therapy were excluded.RESULTS: AKI occurred in 382 of 941 patients (40.6%), and postoperative dialysis was required for 105 patients (11.0%). Renal malperfusion was present preoperatively in 42 patients (5.1%), of whom 69.0% developed postoperative AKI. In multivariable analysis patient-related predictors of AKI included age (per 10 years; odds ratio [OR], 1.30; 95% confidence interval [CI], 1.15-1.48), body mass index >30 kg/m 2 (OR, 2.16; 95% CI, 1.51-3.09), renal malperfusion (OR, 4.39; 95% CI, 2.23-9.07), and other malperfusion (OR, 2.10; 95% CI, 1.55-2.86). Perioperative predictors were cardiopulmonary bypass time (per 10 minutes; OR, 1.04; 95% CI, 1.02-1.07) and red blood cell transfusion (OR per transfused unit, 1.08; 95% CI, 1.06-1.10). Rates of 30-day mortality were 17.0% in the AKI group compared with 6.6% in the non-AKI group (P < .001). In 30-day survivors AKI was an independent predictor of long-term mortality (hazard ratio, 1.86; 95% CI; 1.24-2.79). CONCLUSIONS: AKI is a common complication after surgery for ATAAD and independently predicts adverse long-term outcome. Of note one-third of patients presenting with renal malperfusion did not develop postoperative AKI, possibly because of restoration of renal blood flow with surgical repair. Mortality risk persists beyond the perioperative period, indicating that close clinical follow-up of these patients is required.

AB - BACKGROUND: The aim of this study was to examine the incidence, risk factors, and outcomes of patients with acute kidney injury (AKI) after surgery for acute type A aortic dissection (ATAAD) using the Nordic Consortium for Acute Type A Aortic Dissection registry.METHODS: Patients who underwent ATAAD surgery at 8 Nordic centers from 2005 to 2014 were analyzed for AKI according to the RIFLE criteria. Patients who died intraoperatively, those who had missing baseline or postoperative serum creatinine, and patients on preoperative renal replacement therapy were excluded.RESULTS: AKI occurred in 382 of 941 patients (40.6%), and postoperative dialysis was required for 105 patients (11.0%). Renal malperfusion was present preoperatively in 42 patients (5.1%), of whom 69.0% developed postoperative AKI. In multivariable analysis patient-related predictors of AKI included age (per 10 years; odds ratio [OR], 1.30; 95% confidence interval [CI], 1.15-1.48), body mass index >30 kg/m 2 (OR, 2.16; 95% CI, 1.51-3.09), renal malperfusion (OR, 4.39; 95% CI, 2.23-9.07), and other malperfusion (OR, 2.10; 95% CI, 1.55-2.86). Perioperative predictors were cardiopulmonary bypass time (per 10 minutes; OR, 1.04; 95% CI, 1.02-1.07) and red blood cell transfusion (OR per transfused unit, 1.08; 95% CI, 1.06-1.10). Rates of 30-day mortality were 17.0% in the AKI group compared with 6.6% in the non-AKI group (P < .001). In 30-day survivors AKI was an independent predictor of long-term mortality (hazard ratio, 1.86; 95% CI; 1.24-2.79). CONCLUSIONS: AKI is a common complication after surgery for ATAAD and independently predicts adverse long-term outcome. Of note one-third of patients presenting with renal malperfusion did not develop postoperative AKI, possibly because of restoration of renal blood flow with surgical repair. Mortality risk persists beyond the perioperative period, indicating that close clinical follow-up of these patients is required.

UR - http://www.scopus.com/inward/record.url?scp=85099644198&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2020.07.019

DO - 10.1016/j.athoracsur.2020.07.019

M3 - Journal article

C2 - 32961133

VL - 111

SP - 1292

EP - 1298

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -

ID: 65026881