Cardiopulmonary bypass time is an independent risk factor for acute kidney injury in emergent thoracic aortic surgery: a retrospective cohort study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Thoracic aortic surgery and cardiopulmonary bypass are both associated with development of postoperative acute kidney injury. In this study, we undertook to investigate the relationship between cardiopulmonary bypass time and postoperative acute kidney injury in patients undergoing thoracic aortic surgery for acute DeBakey Type I aortic dissection.

Methods

All patients receiving thoracic aortic surgery for acute DeBakey Type I aortic dissection in Beijing Anzhen hospital from December 2015 to April 2017 were included. Cardiopulmonary bypass time was recorded during surgery. Acute kidney injury was defined based on the Kidney Disease Improving Global Outcomes criteria. A total of 115 consecutive patients were eventually analyzed.

Results

The overall incidence of acute kidney injury was 53.0% ( n = 61). The average age was 47.8 ± 10.7 years; 74.8% were male. Mean cardiopulmonary bypass time was 211 ± 56 min. In-hospital mortality was 7.8%. Multivariate logistic regression revealed that cardiopulmonary bypass time was independently associated with the occurrence of postoperative acute kidney injury after adjust confounding factors (odds ratio = 1.171; 95% confidence interval: 1.002–1.368; P = 0.047).

Conclusions

Cardiopulmonary bypass time is independently associated with an increased hazard of acute kidney injury after thoracic aortic surgery for acute DeBakey Type I aortic dissection. Further understanding of the mechanism of this association is crucial to the design of preventative strategies.

Electronic supplementary material

The online version of this article (10.1186/s13019-019-0907-x) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 29

Record: found
Abstract: found
Article: found

Is Open Access

A comparison of 12 algorithms for matching on the propensity score

Peter C Austin (2013)

Propensity-score matching is increasingly being used to reduce the confounding that can occur in observational studies examining the effects of treatments or interventions on outcomes. We used Monte Carlo simulations to examine the following algorithms for forming matched pairs of treated and untreated subjects: optimal matching, greedy nearest neighbor matching without replacement, and greedy nearest neighbor matching without replacement within specified caliper widths. For each of the latter two algorithms, we examined four different sub-algorithms defined by the order in which treated subjects were selected for matching to an untreated subject: lowest to highest propensity score, highest to lowest propensity score, best match first, and random order. We also examined matching with replacement. We found that (i) nearest neighbor matching induced the same balance in baseline covariates as did optimal matching; (ii) when at least some of the covariates were continuous, caliper matching tended to induce balance on baseline covariates that was at least as good as the other algorithms; (iii) caliper matching tended to result in estimates of treatment effect with less bias compared with optimal and nearest neighbor matching; (iv) optimal and nearest neighbor matching resulted in estimates of treatment effect with negligibly less variability than did caliper matching; (v) caliper matching had amongst the best performance when assessed using mean squared error; (vi) the order in which treated subjects were selected for matching had at most a modest effect on estimation; and (vii) matching with replacement did not have superior performance compared with caliper matching without replacement. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

0 comments Cited 299 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Phenylpropanolamine and the risk of hemorrhagic stroke.

M. Brass, Mark E. Feldmann, J Wilterdink … (2000)

Phenylpropanolamine is commonly found in appetite suppressants and cough or cold remedies. Case reports have linked the use of products containing phenylpropanolamine to hemorrhagic stroke, often after the first use of these products. To study the association, we designed a case-control study. Men and women 18 to 49 years of age were recruited from 43 U.S. hospitals. Eligibility criteria included the occurrence of a subarachnoid or intracerebral hemorrhage within 30 days before enrollment and the absence of a previously diagnosed brain lesion. Random-digit dialing identified two matched control subjects per patient. There were 702 patients and 1376 control subjects. For women, the adjusted odds ratio was 16.58 (95 percent confidence interval, 1.51 to 182.21; P=0.02) for the association between the use of appetite suppressants containing phenylpropanolamine and the risk of a hemorrhagic stroke and 3.13 (95 percent confidence interval, 0.86 to 11.46; P=0.08) for the association with the first use of a product containing phenylpropanolamine. All first uses of phenylpropanolamine involved cough or cold remedies. For men and women combined, the adjusted odds ratio was 1.49 (95 percent confidence interval, 0.84 to 2.64; P=0.17) for the association between the use of a product containing phenylpropanolamine and the risk of a hemorrhagic stroke, 1.23 (95 percent confidence interval, 0.68 to 2.24; P=0.49) for the association with the use of cough or cold remedies that contained phenylpropanolamine, and 15.92 (95 percent confidence interval, 1.38 to 184.13; P=0.03) for the association with the use of appetite suppressants that contained phenylpropanolamine. An analysis in men showed no increased risk of a hemorrhagic stroke in association with the use of cough or cold remedies containing phenylpropanolamine. No men reported the use of appetite suppressants. The results suggest that phenylpropanolamine in appetite suppressants, and possibly in cough and cold remedies, is an independent risk factor for hemorrhagic stroke in women.

0 comments Cited 140 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch?

Lizhong Sun, Chang-Jun Zheng, Yongmin Liu … (2011)

Appropriate surgical management of type A dissection is a critical factor for achieving satisfactory outcome, but the choice of optimal procedure is controversial. We retrospectively reviewed our experience with aortic arch replacement for type A dissection involving the arch. Excluding 14 cases of subtotal or total aortic replacement, 411 of 544 patients with type A dissection (stented elephant trunk=291, conventional surgical repair=120) underwent aortic arch replacement between January 2003 and September 2008. In-hospital mortality was 3.09% (9 of 291) for stented (acute=4.73%, 7 of 148; chronic=1.40%, 2 of 143) and 5.00% (6 of 120) for conventional repairs (acute=6.06%, 4 of 66; chronic=3.70%, 2 of 54). Spinal cord injury was 2.41% (7 of 291) in the stented and 0.83% (1 of 120) in the conventional group. The overall prevalence of stroke was 1.95% (8 of 411) (stented=2.41%, 7 of 291; conventional=0.83, 1 of 120). Secondary intervention was 2.34% (5 of 214) for acute dissection (stented=1 and conventional=4; P=0.031) and 3.05% (6 of 197) for chronic dissection (stented=4 and conventional=2; P=0.661) during follow-up. Obliteration of the false lumen around the stented elephant trunk occurred in 94.2% (130 of 138) of patients with acute dissection and in 92.0% (126 of 137) of patients with chronic dissection. Total arch replacement combined with stented elephant trunk implantation demonstrated the superiority of the combination of the surgical and interventional approaches while avoiding the weaknesses associated with the individual methods. The encouraging surgical results could enable this procedure to become the new "standard" therapy for type A dissection involving repair of the aortic arch.

0 comments Cited 109 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Shijun Xu: shijxu116@126.com

Jie Liu: liujie3514@163.com

Lei Li: alotofmoon@126.com

Zining Wu: wuzining66@sina.com

Jiachen Li: lijiachen0915@126.com

Yongmin Liu: liuyongmin100@sina.com

Junming Zhu: anzhenzjm@126.com

Lizhong Sun: lizhongsun@outlook.com

Xinliang Guan: +86-010-64456613 , guanxl119@sina.com

Ming Gong: +86-010-64456613 , gongmaster@126.com

Hongjia Zhang: +86-010-64456216 , zhanghongjia722@ccmu.edu.cn

Journal

Journal ID (nlm-ta): J Cardiothorac Surg

Journal ID (iso-abbrev): J Cardiothorac Surg

Title: Journal of Cardiothoracic Surgery

Publisher: BioMed Central (London )

ISSN (Electronic): 1749-8090

Publication date (Electronic): 7 May 2019

Publication date PMC-release: 7 May 2019

Publication date Collection: 2019

Volume: 14

Electronic Location Identifier: 90

Affiliations

[1 ]ISNI 0000 0004 0369 153X, GRID grid.24696.3f, Department of Cardiac Surgery, Beijing Aortic Disease Center, , Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular Prostheses, ; No.2 Anzhen Street, Beijing, 100029 China

[2 ]ISNI 0000 0004 1761 8894, GRID grid.414252.4, Department of Vascular and Endovascular Surgery, , Chinese PLA General Hospital, ; Beijing, 100853 China

Article

Publisher ID: 907

DOI: 10.1186/s13019-019-0907-x

PMC ID: 6505293

PubMed ID: 31064409

SO-VID: a6b32305-f298-4c1a-880f-b3d8d081b573

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 12 February 2019

Date accepted : 22 April 2019

Funding

Funded by: National Key R&D Program of China

Award ID: 2017YFC1308000

Funded by: The Capital Health Research and Development of Special

Award ID: 2018-2-2-66

Award Recipient : Ming Gong

Funded by: the National Science Foundation of China

Award ID: 81600362

Award Recipient : Xinliang Guan

Funded by: Beijing Municipal Administration of Hospitals’ Youth Program

Award ID: QML20170602

Award Recipient : Xinliang Guan

Funded by: the Beijing Lab for Cardiovascular Precision Medicine, Beijing, China

Award ID: PXM2017_014226_000037

Custom metadata

ScienceOpen disciplines: Surgery

Keywords: acute kidney injury,aortic dissection,cardiopulmonary bypass,risk factor,thoracic aortic surgery

Data availability:

ScienceOpen disciplines: Surgery

Keywords: acute kidney injury, aortic dissection, cardiopulmonary bypass, risk factor, thoracic aortic surgery

Cardiopulmonary bypass time is an independent risk factor for acute kidney injury in emergent thoracic aortic surgery: a retrospective cohort study

Read this article at

Abstract

Background

Methods

Results

Conclusions

Electronic supplementary material

Related collections

Karger: Nephrology

Most cited references 29

A comparison of 12 algorithms for matching on the propensity score

Phenylpropanolamine and the risk of hemorrhagic stroke.

Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch?

Author and article information

Contributors

Journal

Affiliations

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 160

Cited by 29

Most referenced authors 482