TY - JOUR
T1 - Acute Kidney Injury in Patients Undergoing Surgery for Type A Acute Aortic Dissection
AU - Arnaoutakis, George J.
AU - Ogami, Takuya
AU - Patel, Himanshu J.
AU - Pai, Chih Wen
AU - Woznicki, Elise M.
AU - Brinster, Derek R.
AU - Leshnower, Bradley G.
AU - Serna-Gallegos, Derek
AU - Bekeredjian, Raffi
AU - Sundt, Thoralf M.
AU - Shaffer, Andrew W.
AU - Peterson, Mark D.
AU - Geuzebroek, Guillaume S.C.
AU - Eagle, Kim A.
AU - Trimarchi, Santi
AU - Sultan, Ibrahim
N1 - Funding Information:
The authors have no funding sources to disclose. George J. Arnaoutakis receives consulting fees for Terumo Aortic. Ibrahim Sultan receives institutional research support from Abbott, Atricure, cryolife, and Medtronic. None related to this manuscript. All other authors declare that they have no conflicts of interest.
Publisher Copyright:
© 2023 The Society of Thoracic Surgeons
PY - 2023/4
Y1 - 2023/4
N2 - Background: Acute kidney injury (AKI) after repair of type A acute aortic dissection (TAAAD) has been shown to affect both short- and long-term outcomes. This study aimed to validate the impact of postoperative AKI on in-hospital and long-term outcomes in a large population of dissection patients presenting to multinational aortic centers. Additionally, we assessed risk factors for AKI including surgical details. Methods: Patients undergoing surgical repair for TAAAD enrolled in the International Registry of Acute Aortic Dissection database were evaluated to determine the incidence and risk factors for the development of AKI. Results: A total of 3307 patients were identified. There were 761 (23%) patients with postoperative AKI (AKI group) vs 2546 patients without (77%, non-AKI group). The AKI group had a higher rate of in-hospital mortality (n = 193, 25.4% vs n = 122, 4.8% in the non-AKI group, P < .001). Additional postoperative complications were also more common in the AKI group including postoperative cerebrovascular accident, reexploration for bleeding, and prolonged ventilation. Independent baseline characteristics associated with AKI included a history of hypertension, diabetes, chronic kidney disease, evidence of malperfusion on presentation, distal extent of dissection to abdominal aorta, and longer cardiopulmonary bypass time. Kaplan-Meier survival curves revealed decreased 5-year survival among the AKI group (P < .001). Conclusions: AKI occurs commonly after TAAAD repair and is associated with a significantly increased risk of operative and long-term mortality. In this large study using the International Registry of Acute Aortic Dissection database, several factors were elucidated that may affect risk of AKI.
AB - Background: Acute kidney injury (AKI) after repair of type A acute aortic dissection (TAAAD) has been shown to affect both short- and long-term outcomes. This study aimed to validate the impact of postoperative AKI on in-hospital and long-term outcomes in a large population of dissection patients presenting to multinational aortic centers. Additionally, we assessed risk factors for AKI including surgical details. Methods: Patients undergoing surgical repair for TAAAD enrolled in the International Registry of Acute Aortic Dissection database were evaluated to determine the incidence and risk factors for the development of AKI. Results: A total of 3307 patients were identified. There were 761 (23%) patients with postoperative AKI (AKI group) vs 2546 patients without (77%, non-AKI group). The AKI group had a higher rate of in-hospital mortality (n = 193, 25.4% vs n = 122, 4.8% in the non-AKI group, P < .001). Additional postoperative complications were also more common in the AKI group including postoperative cerebrovascular accident, reexploration for bleeding, and prolonged ventilation. Independent baseline characteristics associated with AKI included a history of hypertension, diabetes, chronic kidney disease, evidence of malperfusion on presentation, distal extent of dissection to abdominal aorta, and longer cardiopulmonary bypass time. Kaplan-Meier survival curves revealed decreased 5-year survival among the AKI group (P < .001). Conclusions: AKI occurs commonly after TAAAD repair and is associated with a significantly increased risk of operative and long-term mortality. In this large study using the International Registry of Acute Aortic Dissection database, several factors were elucidated that may affect risk of AKI.
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U2 - 10.1016/j.athoracsur.2022.10.037
DO - 10.1016/j.athoracsur.2022.10.037
M3 - Article
C2 - 36370884
AN - SCOPUS:85143875773
SN - 0003-4975
VL - 115
SP - 879
EP - 885
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 4
ER -
