Abstract
Abstract
Background
Type A acute aortic dissection is a life-threatening disease associated with adverse clinical outcomes. Acute kidney injury (AKI) is common after surgery. However, the relationship between intraoperative blood transfusion and postoperative AKI remains unclear.
Methods
The records of 130 patients who underwent type A acute aortic dissection surgery from January 2015 to December 2018 were retrospectively analyzed. According to the Kidney Disease Improving Global Outcomes criteria, postoperative AKI was defined based on serum creatinine concentration. Multivariable logistic regression analysis was applied to estimate the independent association between intraoperative blood transfusion volume and the risk of postoperative AKI.
Results
Postoperative AKI was observed in 82 patients (63.08%). The in-hospital mortality was 16.15% (n = 21). Multivariate logistic regression showed that the amount of intraoperative blood transfusion was independently associated with the risk of postoperative AKI in a dose-dependent manner. Every 200 ml increment of blood transfusion volume was associated with a 31% increase in AKI risk (odds ratio 1.31 and 95% confidence interval 1.01–1.71).
Conclusions
Intraoperative transfusion volume may increase the incidence of postoperative AKI. The mechanism and influence of transfusion thresholds on AKI need to be explored in the future.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference28 articles.
1. Li Y, Yang N, Duan W, Liu S, Yu S, Yi D. Acute aortic dissection in China. Am J Cardiol. 2012;110(7):1056–61.
2. Ko T, Higashitani M, Sato A, Uemura Y, Norimatsu T, Mahara K, et al. Impact of acute kidney injury on early to long-term outcomes in patients who underwent surgery for type a acute aortic dissection. Am J Cardiol. 2015;116(3):463–8.
3. Karrowni W, Vora AN, Dai D, Wojdyla D, Dakik H, Rao SV. Blood transfusion and the risk of acute kidney injury among patients with acute coronary syndrome undergoing percutaneous coronary intervention. Circ Cardiovasc Interv. 2016;9(9):e003279.
4. Mehta RL, Burdmann EA, Cerda J, Feehally J, Finkelstein F, Garcia-Garcia G, et al. Recognition and management of acute kidney injury in the International Society of Nephrology 0by25 Global Snapshot: a multinational cross-sectional study. Lancet. 2016;387(10032):2017–25.
5. Freeland K, Hamidian JA, Duvall LM, Mancini MC. Postoperative blood transfusion is an independent predictor of acute kidney injury in cardiac surgery patients. J Nephropathol. 2015;4(4):121–6.