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Incidence and predictors of myocardial and kidney injury following endovascular aortic repair: a retrospective cohort study
Incidence and predictors of myocardial and kidney injury following endovascular aortic repair: a retrospective cohort study
- Source :
- Canadian Journal of Anesthesia; November 2019, Vol. 66 Issue: 11 p1338-1346, 9p
- Publication Year :
- 2019
-
Abstract
- Purpose: We performed a retrospective cohort study in patients who underwent endovascular aneurysm repair (EVAR) to determine the incidence and predictors of myocardial injury and acute kidney injury (AKI). Methods: We included 267 consecutive patients who underwent EVAR at two tertiary centres in Canada and Poland. The primary outcome was myocardial injury during hospital stay after EVAR defined as a troponin elevation (ultra-sensitivity troponin I Vidas = 19 ng·L<superscript>-1</superscript>, non-high-sensitivity troponin I Vidas = 0.01 µg·L<superscript>-1</superscript>, high-sensitivity troponin T = 20 ng·L<superscript>-1</superscript>, non-high-sensitivity troponin T = 0.03 ng·mL<superscript>-1</superscript>). The secondary outcome was AKI defined using the stage 1 of the Acute Kidney Injury Network criteria. Results: Myocardial injury occurred in 78/267 patients (29%; 95% confidence interval [CI], 24.1 to 34.9) and with AKI occurring in 25/267 (9.4%; 95% CI, 6.4 to 13.5). In a multivariable analysis, the following variables were associated with an increased risk of myocardial injury: age (adjusted odds ratio [aOR], 1.65 per ten-year increase; 95% CI, 1.09 to 2.49), Revised Cardiac Risk Index score =3 (aOR, 2.85; 95% CI, 1.26 to 6.41), The American Society of Anesthesiology physical status score 4 (aOR, 2.24; 95% CI, 1.12 to 4.47), duration of surgery (aOR, 1.27 per each hour; 95% CI, 1.00 to 1.61), and perioperative drop in hemoglobin (aOR, 3.35 per 10 g·dL<superscript>-1</superscript>decrease; 95% CI, 1.00 to 11.3). Predictors of AKI were duration of surgery (aOR, 1.72 per hour; 95% CI, 1.36 to 2.17), a preoperative estimated glomerular filtration rate (eGFR) of 30-59 mL·min<superscript>-1</superscript>(aOR, 3.82; 95% CI, 1.42 to 10.3), and an eGFR &lt; 30 mL·min<superscript>-1</superscript>(aOR, 37.0; 95% CI, 7.1 to 193.8). Conclusion: Myocardial injury and AKI are frequent during hospital stay after EVAR and warrant further investigation in prospective studies.
Details
- Language :
- English
- ISSN :
- 0832610X and 14968975
- Volume :
- 66
- Issue :
- 11
- Database :
- Supplemental Index
- Journal :
- Canadian Journal of Anesthesia
- Publication Type :
- Periodical
- Accession number :
- ejs50458948
- Full Text :
- https://doi.org/10.1007/s12630-019-01438-0