Impact of Intraoperative Hypotension on Risk of Acute Kidney Injury After Off-pump Coronary Artery Bypass Grafting Surgery: A Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 821
- 试验地点
- 1
- 主要终点
- Incidence of acute kidney injury (AKI) within 7 days after surgery
研究概览
简要总结
Acute renal injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Hypotension is an important risk factor for the development of AKI after noncardiac surgery. However, the association between intraoperative hypotension and AKI after cardiac surgery has not been fully investigated. The purpose of this study is to analyze the association between intraoperative hypotension and acute kidney injury after off-pump coronary artery bypass surgery.
详细描述
Acute renal injury (AKI) is a common complication after cardiac surgery. Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased in-hospital mortality, prolonged length of stay in the Intensive Care Unit and hospital, and higher costs of care. Intraoperative hypotension is an important risk factor for the development of AKI after noncardiac surgery. In a retrospective analysis, a mean arterial pressure of less than 55 mmHg predicted the occurrence of adverse cardiac- and renal-related outcomes after noncardiac surgery. Other studies also revealed that intraoperative hypotension is associated with increased incidence of AKI and 1-year mortality after noncardiac surgery. In patients undergoing cardiac surgery, 30-day mortality is proportionate to the extent of systolic blood pressure excursions outside the range of 75 to 135 mm Hg intraoperatively. However, the correlation between intraoperative hypotension and the development of AKI after cardiac surgery has not been fully investigated. The purpose of this study is to analyze the association between intraoperative hypotension and the risk of acute kidney injury after off-pump coronary artery bypass surgery.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 50 years;
- •Underwent off-pump CABG surgery.
排除标准
- •End-stage renal disease requiring renal-replacement therapy;
- •Emergency surgery;
- •Kidney transplantation within 3 months;
- •Missing data.
结局指标
主要结局
Incidence of acute kidney injury (AKI) within 7 days after surgery
时间窗: Up to 7 days after surgery
Development of AKI within 7 days after surgery is diagnosed according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria
次要结局
- Duration of mechanical ventilation after surgery(Up to 30 days after surgery)
- Length of stay in hospital after surgery(Up to 30 days after surgery)
- Length of stay in intensive care unit (ICU) after surgery(Up to 30 days after surgery)
- Incidence of major adverse cardiovascular events (MACEs) within 30 days after surgery(Up to 30 days after surgery)
- Classification of AKI within 7 days after surgery(Up to 7 days after surgery)
- Incidence of non-MACE complications within 30 days after surgery(Up to 30 days after surgery)
- All-cause mortality in hospital(Up to 30 days after surgery)
研究者
Dong-Xin Wang
Professor and Chairman, Department of Anaesthesiology and Critical Care Medicine
Peking University First Hospital