Cargando…
Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introd...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321429/ https://www.ncbi.nlm.nih.gov/pubmed/28225801 http://dx.doi.org/10.1371/journal.pone.0172021 |
_version_ | 1782509696986382336 |
---|---|
author | Duque-Sosa, Paula Martínez-Urbistondo, Diego Echarri, Gemma Callejas, Raquel Iribarren, María Josefa Rábago, Gregorio Monedero, Pablo |
author_facet | Duque-Sosa, Paula Martínez-Urbistondo, Diego Echarri, Gemma Callejas, Raquel Iribarren, María Josefa Rábago, Gregorio Monedero, Pablo |
author_sort | Duque-Sosa, Paula |
collection | PubMed |
description | Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain. Exclusion criteria were patients on renal replacement therapy, who needed a reoperation because of bleeding and/or with missing perioperative hemoglobin or creatinine values. Using a multivariate regression analysis, we found that a pHb-AUC <19 g/dL was an independent risk factor for CSA-AKI even after adjustment for intraoperative red blood cell transfusion (OR 1.41, p <0.05). It was also associated with mortality (OR 2.48, p <0.01) and prolonged hospital length of stay (4.67 ± 0.99 days, p <0.001) |
format | Online Article Text |
id | pubmed-5321429 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-53214292017-03-09 Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study Duque-Sosa, Paula Martínez-Urbistondo, Diego Echarri, Gemma Callejas, Raquel Iribarren, María Josefa Rábago, Gregorio Monedero, Pablo PLoS One Research Article Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain. Exclusion criteria were patients on renal replacement therapy, who needed a reoperation because of bleeding and/or with missing perioperative hemoglobin or creatinine values. Using a multivariate regression analysis, we found that a pHb-AUC <19 g/dL was an independent risk factor for CSA-AKI even after adjustment for intraoperative red blood cell transfusion (OR 1.41, p <0.05). It was also associated with mortality (OR 2.48, p <0.01) and prolonged hospital length of stay (4.67 ± 0.99 days, p <0.001) Public Library of Science 2017-02-22 /pmc/articles/PMC5321429/ /pubmed/28225801 http://dx.doi.org/10.1371/journal.pone.0172021 Text en © 2017 Duque-Sosa et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Duque-Sosa, Paula Martínez-Urbistondo, Diego Echarri, Gemma Callejas, Raquel Iribarren, María Josefa Rábago, Gregorio Monedero, Pablo Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
title | Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
title_full | Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
title_fullStr | Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
title_full_unstemmed | Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
title_short | Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
title_sort | perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. results from a spanish multicenter retrospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321429/ https://www.ncbi.nlm.nih.gov/pubmed/28225801 http://dx.doi.org/10.1371/journal.pone.0172021 |
work_keys_str_mv | AT duquesosapaula perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT martinezurbistondodiego perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT echarrigemma perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT callejasraquel perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT iribarrenmariajosefa perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT rabagogregorio perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT monederopablo perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy AT perioperativehemoglobinareaunderthecurveisanindependentpredictorofrenalfailureaftercardiacsurgeryresultsfromaspanishmulticenterretrospectivecohortstudy |