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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...

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Autores principales: Duque-Sosa, Paula, Martínez-Urbistondo, Diego, Echarri, Gemma, Callejas, Raquel, Iribarren, María Josefa, Rábago, Gregorio, Monedero, Pablo
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
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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)
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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
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