Jiayang Wang1,2, Wenyuan Yu1, Guangyao Zhai3, Nan Liu2, Lizhong Sun1, Junming Zhu1. 1. Department of Cardiac Surgery, Beijing An Zhen Hospital Capital Medical University, Beijing 100029, China. 2. Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing 100029, China. 3. Department of Cardiology, Beijing An Zhen Hospital Capital Medical University, Beijing 100029, China.
Abstract
BACKGROUND: This meta-analysis aims to investigate the effects of postoperative acute kidney injury (AKI) on 30-day postoperative outcomes and the independent risk factors for postoperative AKI in patients with type A acute aortic dissection (TAAD). METHODS: Relevant reports published between January 1, 2011 and May 31, 2017 were searched in multiple electronic literature databases. A total of seven eligible articles were included in the meta-analysis. RESULTS: Postoperative AKI was associated with 249% increase in 30-day postoperative mortality [odds ratio (OR): 3.49; 95% confidence interval (CI): 2.17-5.59; P<0.0001]. Subgroup analysis revealed that patients with stage II/III AKI showed 445% increase in 30-day postoperative mortality compared with the control group (OR: 5.45; 95% CI: 2.87-10.36; P<0.0001). Postoperative AKI was also associated with 143%, 432%, and 126% increase in the incidences of 30-day postoperative stroke, bleeding, and respiratory complications, respectively. Notably, high body mass index (BMI), advanced age, and perioperative sepsis were independent risk factors for postoperative AKI in patients with TAAD. CONCLUSIONS: This meta-analysis firstly provided clinical evidence showing the adverse effects of postoperative AKI on 30-day postoperative outcomes in patients with TAAD and identified high BMI, advanced age, and perioperative sepsis as the independent risk factors for postoperative AKI. These findings suggest that preventive or therapeutic methods to effectively manage postoperative AKI may improve 30-day postoperative outcomes in patients with TAAD.
BACKGROUND: This meta-analysis aims to investigate the effects of postoperative acute kidney injury (AKI) on 30-day postoperative outcomes and the independent risk factors for postoperative AKI in patients with type A acute aortic dissection (TAAD). METHODS: Relevant reports published between January 1, 2011 and May 31, 2017 were searched in multiple electronic literature databases. A total of seven eligible articles were included in the meta-analysis. RESULTS: Postoperative AKI was associated with 249% increase in 30-day postoperative mortality [odds ratio (OR): 3.49; 95% confidence interval (CI): 2.17-5.59; P<0.0001]. Subgroup analysis revealed that patients with stage II/III AKI showed 445% increase in 30-day postoperative mortality compared with the control group (OR: 5.45; 95% CI: 2.87-10.36; P<0.0001). Postoperative AKI was also associated with 143%, 432%, and 126% increase in the incidences of 30-day postoperative stroke, bleeding, and respiratory complications, respectively. Notably, high body mass index (BMI), advanced age, and perioperative sepsis were independent risk factors for postoperative AKI in patients with TAAD. CONCLUSIONS: This meta-analysis firstly provided clinical evidence showing the adverse effects of postoperative AKI on 30-day postoperative outcomes in patients with TAAD and identified high BMI, advanced age, and perioperative sepsis as the independent risk factors for postoperative AKI. These findings suggest that preventive or therapeutic methods to effectively manage postoperative AKI may improve 30-day postoperative outcomes in patients with TAAD.
Entities:
Keywords:
30-day mortality; Acute kidney injury (AKI); postoperative; risk factors; type A acute aortic dissection (TAAD)
Authors: Anthony L Estrera; Charles C Miller; Jennifer Goodrick; Eyal E Porat; Paul E Achouh; Jayesh Dhareshwar; Riad Meada; Ali Azizzadeh; Hazim J Safi Journal: Ann Thorac Surg Date: 2007-02 Impact factor: 4.330
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Crit Care Med Date: 2003-04 Impact factor: 7.598
Authors: P G Hagan; C A Nienaber; E M Isselbacher; D Bruckman; D J Karavite; P L Russman; A Evangelista; R Fattori; T Suzuki; J K Oh; A G Moore; J F Malouf; L A Pape; C Gaca; U Sechtem; S Lenferink; H J Deutsch; H Diedrichs; J Marcos y Robles; A Llovet; D Gilon; S K Das; W F Armstrong; G M Deeb; K A Eagle Journal: JAMA Date: 2000-02-16 Impact factor: 56.272
Authors: J I Fann; J A Smith; D C Miller; R S Mitchell; K A Moore; G Grunkemeier; E B Stinson; P E Oyer; B A Reitz; N E Shumway Journal: Circulation Date: 1995-11-01 Impact factor: 29.690
Authors: J Stewart Collins; Arturo Evangelista; Christoph A Nienaber; Eduardo Bossone; Jianming Fang; Jeanna V Cooper; Dean E Smith; Patrick T O'Gara; Truls Myrmel; Dan Gilon; Eric M Isselbacher; Marc Penn; Linda A Pape; Kim A Eagle; Rajendra H Mehta Journal: Circulation Date: 2004-09-14 Impact factor: 29.690