Acute Renal Dysfunction Does Not Develop More Frequently Among Octogenarians Compared to Septuagenarians after Cardiac Surgery

Ried, Michael; Haneya, Assad; Kolat, Philipp; Potzger, T; Puehler, Thomas; Schmid, C; Diez, Claudius

doi:10.1055/s-0031-1295567

Cited by 5 publications

(9 citation statements)

References 22 publications

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“…Arterial cannulation was performed in the right axillary artery, femoral artery or ascending aorta, and venous cannulations were bicaval or in the right appendage according to type of surgery. Cardiopulmonary bypass was routinely instituted at 2.2 to 2.5 L/min/m 2 . Aprotinin and tranexamic acid were not used for coagulation support.…”

Section: Methodsmentioning

confidence: 99%

“…Acute kidney injury (AKI) after cardiovascular surgery is a serious complication and is associated with increased medical cost and substantial mortality. 1 , 2 The incidence of AKI after cardiovascular surgery has been reported to be as high as 55% and the incidence of renal replacement therapy (RRT) to be 2% to 8%. 1 , 3 – 11 Acute kidney injury is associated with up to 60% mortality rates in cardiac surgery patients, 12 and the risk of death associated with AKI remains high for 10 years, even for those patients with complete renal recovery.…”

Section: Introductionmentioning

confidence: 99%

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Association Between the Neutrophil/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery

Kim

Park

et al. 2015

Medicine

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between the Neutrophil/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery

Kim

Park

et al. 2015

Medicine

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“…Acute kidney injury (AKI) after cardiac surgery is one of most serious complications and is associated with increased mortality. [1][2][3][4] The incidence of AKI after aortic surgery has been reported to range from 18 to 55%, 1,[5][6][7] and the incidence of renal replacement therapy (RRT) after aortic surgery ranges from 2 to 8%. 5,6,8 Because there is no effective therapeutic regimen for AKI at present, 9 it is important to identify risk factors and prevent postoperative AKI.…”

Section: Introductionmentioning

confidence: 99%

Can We Really Predict Postoperative Acute Kidney Injury after Aortic Surgery? Diagnostic Accuracy of Risk Scores Using Gray Zone Approach

Lee

Kim

et al. 2015

Thorac cardiovasc Surg

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Background Several risk scores have been developed to predict acute kidney injury (AKI) after cardiac surgery. We evaluated the accuracy of eight prediction models using the gray zone approach in patients who underwent aortic surgery. Patients and Methods We retrospectively applied the risk scores of Palomba, Wijeysundera, Mehta, Thakar, Brown, Aronson, Fortescue, and Rhamanian to 375 consecutive adult patients undergoing aortic surgery with cardiopulmonary bypass. The area under the receiver operating characteristic curve (AUC) and gray zone approach were used to evaluate the accuracy of the eight models for prediction of AKI, as defined by the RIFLE criteria. Results The incidence of AKI was 29% (109/375). The AUC for predicting AKI requiring dialysis ranged from 0.66 to 0.84, excluding the score described by Brown et al (0.50). The AUC for predicting the RIFLE criteria of risk and higher ranged from 0.57 to 0.68. The application of gray zone approach resulted in more than half of the patients falling in the gray zone: 275 patients (73%) for Palomba, 221 (59%) for Wijeysundera, 292 (78%) for Mehta, 311 (83%) for Thakar, 329 (88%) for Brown, 291 (78%) for Aronson, 205 (54%) for Fortescue, and 308 (82%) for Rhamanian. Conclusion More than half of the patients in our study sample were in the gray zone of eight scoring models for AKI prediction. The two cutoffs of the gray zone can be used when using risk models. A surgery-specific and more accurate prediction model with a smaller gray zone is required for patients undergoing aortic surgery.

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“…However, in our univariate analysis, no significant difference was found between the patients in the AKI group and non-AKI group in age (p = 0.4, Table 1 ). As explained by [ 32 ], octogenarians could be used to their chronic-reduced renal function and they might not be suffering so often from a worse renal function postoperative and without causing any relevant clinical consequences.…”

Section: Discussionmentioning

confidence: 99%

Incidence, risk factors and outcomes of acute kidney injury in surgical intensive care unit octogenarians at the Jordan University Hospital

et al. 2023

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Background Acute kidney damage (AKI) is among the most severe consequences observed in surgical intensive care units (SICUs). We aim to observe the incidence, risk factors, and outcomes of acute kidney injury in SICU octogenarians. Methods A cross-sectional retrospective study was conducted at the SICU of Jordan University Hospital (JUH), a tertiary teaching hospital in a developing country, between January 2018 and December 2019. Patients who were 80 years or older at the time of data collection were included. The definition of AKI was based on Kidney Disease Improving Global Outcomes (KDIGO) criteria. Demographic, clinical, and laboratory data were reviewed. Results A total number of 168 patients were included. The mean age was 84.0 ± 3.8 years, and 54.8% of the participants were women. Of those, 115 (68.5%) had surgery before or during ICU stay, and 28.7% of the patients’ surgeries were an emergency surgery. Also, 47.8% of surgeries were considered by anesthesia to be high-risk surgeries. A total of 55 patients (32.7%) developed AKI during their SICU stay. The factors that were significantly associated with AKI in the ICU patients included use of beta blocker [AOR: 3.7; 95% CI: 1.2–11.8; p = 0.025], and inotropes [AOR:4.0; 95% CI: 1.2–13.3; p = 0.03]. The factors that were significantly associated with mortality in the ICU included using mechanical ventilation [AOR:18.7; 95% CI: 2.4-141.9; p = 0.005] and inotropes use [AOR: 12.3; 95% CI: 1.2-120.7; p = 0.031]. Conclusions The incidence of AKI during SICU stay in this study was 32.7% and it was significantly associated with the use of beta blockers, mechanical ventilation, and inotropes. The mortality rate among octogenarians who developed AKI during SICU stay was 36.4%. Further studies are needed globally to assess the incidence of AKI in octogenarian surgical patients and identify risk factors to provide preventative measurements and strategies.

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Acute Renal Dysfunction Does Not Develop More Frequently Among Octogenarians Compared to Septuagenarians after Cardiac Surgery

Abstract: Octogenarians do not develop acute kidney failure more frequently than their matched septuagenarian counterparts. They can be operated on at an acceptable risk for morbidity and mortality. Preoperative impaired renal function is associated with higher risk for mortality in septuagenarians.

Cited by 5 publications

References 22 publications

Association Between the Neutrophil/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery

Association Between the Neutrophil/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery

Can We Really Predict Postoperative Acute Kidney Injury after Aortic Surgery? Diagnostic Accuracy of Risk Scores Using Gray Zone Approach

Incidence, risk factors and outcomes of acute kidney injury in surgical intensive care unit octogenarians at the Jordan University Hospital

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