title: RIFLE criteria for cardiac surgery-associated acute kidney injury: risk factors and outcomes.
abstract: The aims of this study were to identify risk factors and evaluate the association with clinical outcomes of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI). Data from 2488 consecutive adult patients were analyzed. Patients were classified as having CSA-AKI based on the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria using peak postoperative creatinine in the postoperative intensive care unit (ICU). Multiple stepwise logistic regression analysis was used to identify independent risk factors for CSA-AKI. CSA-AKI occurred in 584 patients (23.5%). CSA-AKI patients had significantly longer aortic cross-clamp and cardiopulmonary bypass times. Furthermore, CSA-AKI patients had higher hospital mortality (5.5% vs 1.5%, P<.001) and significantly longer ICU and hospital stays. Independent risk factors for CSA-AKI were age, peripheral vascular disease, hypertension, left ventricular ejection fraction, cardiopulmonary bypass time, and surgery on the thoracic aorta. In conclusion, patients who develop CSA-AKI have a higher preoperative risk profile, more complex surgery, and worse clinical outcomes.
authors.affiliation: Division of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy. adonofrio@hotmail.it
authors.forename: Augusto
authors.initials: A
authors.lastname: D'Onofrio
authors.forename: Dinna
authors.initials: D
authors.lastname: Cruz
authors.forename: Irene
authors.initials: I
authors.lastname: Bolgan
authors.forename: Stefano
authors.initials: S
authors.lastname: Auriemma
authors.forename: Giovanni D
authors.initials: GD
authors.lastname: Cresce
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fabbri
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016001:Confidence Intervals; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome