The association of postcardiac surgery acute kidney injury with intraoperative systolic blood pressure hypotension.
Published
Journal Article
Background. Postoperative acute kidney injury (AKI) is associated with high mortality and substantial cost after aortocoronary bypass graft (CABG) surgery. We tested the hypothesis that intraoperative systolic blood pressure variation is associated with postoperative AKI. Methods. We gathered demographic, procedural, blood pressure, and renal outcome data for 7,247 CABG surgeries at a single institution between 1996 and 2005. A development/validation cohort methodology was randomly divided (66% and 33%, resp.). Peak postoperative serum creatinine rise relative to baseline (%ΔCr) was the primary AKI outcome variable. Markers reflective of intraoperative systolic blood pressure variation were derived for each patient including (1) peak and nadir values (absolute and relative to baseline) and (2) excursion episodes beyond selected thresholds (by duration, frequency, and duration × degree). Each marker of systolic blood pressure variation was then separately evaluated for association with AKI using linear regression models with adjustment for several known risk factors (age, aprotinin use, congestive heart failure, previous myocardial infarction, baseline creatinine, bypass time, diabetes, weight, concomitant valve surgery, gender, and preoperative pulse pressure). Results. An association was identified between systolic blood pressure relative to baseline and postoperative AKI (P < 0.006). Conclusions. In CABG surgery patients, intraoperative systolic blood pressure decrease relative to baseline systolic blood pressure is independently associated with postoperative AKI.
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Duke Authors
Cited Authors
- Aronson, S; Phillips-Bute, B; Stafford-Smith, M; Fontes, M; Gaca, J; Mathew, JP; Newman, MF
Published Date
- 2013
Published In
Volume / Issue
- 2013 /
Start / End Page
- 174091 -
PubMed ID
- 24324489
Pubmed Central ID
- 24324489
International Standard Serial Number (ISSN)
- 1687-6962
Digital Object Identifier (DOI)
- 10.1155/2013/174091
Language
- eng
Conference Location
- United States