Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery.

Published

Journal Article

BACKGROUND: Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperative nadir platelet counts are associated with acute kidney injury (AKI) and mortality after coronary artery bypass grafting (CABG) surgery. METHODS: The authors evaluated 4,217 adult patients who underwent CABG surgery. Postoperative nadir platelet counts were defined as the lowest in-hospital values and were used as a continuous predictor of postoperative AKI and mortality. Nadir values in the lowest 10th percentile were also used as a categorical predictor. Multivariable logistic regression and Cox proportional hazard models examined the association between postoperative platelet counts, postoperative AKI, and mortality. RESULTS: The median postoperative nadir platelet count was 121 × 10/l. The incidence of postoperative AKI was 54%, including 9.5% (215 patients) and 3.4% (76 patients) who experienced stages II and III AKI, respectively. For every 30 × 10/l decrease in platelet counts, the risk for postoperative AKI increased by 14% (adjusted odds ratio, 1.14; 95% CI, 1.09 to 1.20; P < 0.0001). Patients with platelet counts in the lowest 10th percentile were three times more likely to progress to a higher severity of postoperative AKI (adjusted proportional odds ratio, 3.04; 95% CI, 2.26 to 4.07; P < 0.0001) and had associated increased risk for mortality immediately after surgery (adjusted hazard ratio, 5.46; 95% CI, 3.79 to 7.89; P < 0.0001). CONCLUSION: The authors found a significant association between postoperative nadir platelet counts and AKI and short-term mortality after CABG surgery.

Full Text

Duke Authors

Cited Authors

  • Kertai, MD; Zhou, S; Karhausen, JA; Cooter, M; Jooste, E; Li, Y-J; White, WD; Aronson, S; Podgoreanu, MV; Gaca, J; Welsby, IJ; Levy, JH; Stafford-Smith, M; Mathew, JP; Fontes, ML

Published Date

  • February 2016

Published In

Volume / Issue

  • 124 / 2

Start / End Page

  • 339 - 352

PubMed ID

  • 26599400

Pubmed Central ID

  • 26599400

Electronic International Standard Serial Number (EISSN)

  • 1528-1175

Digital Object Identifier (DOI)

  • 10.1097/ALN.0000000000000959

Language

  • eng

Conference Location

  • United States