Acute kidney injury following coronary artery bypass grafting: early mortality and postoperative complications.
OBJECTIVE
To investigate the prognostic importance of acute kidney injury on early mortality, postoperative stroke, and mediastinitis in patients undergoing a first isolated coronary artery bypass grafting.


METHODS
7594 patients undergoing coronary artery bypass grafting with information on pre- and postoperative serum-creatinine values were included. Patients were classified using the Acute Kidney Injury Network classification. Odds ratios (OR) for mortality and postoperative complications within 60 days of surgery were calculated after adjustment for confounders separately for stage 1 and for stages 2 and 3 together.


RESULTS
1047 (14%) patients developed acute kidney injury. There were 132 (1.7%) deaths, 103 (1.4%) strokes and 118 (1.6%) cases of mediastinitis during follow-up. Among patients in stage 1 the adjusted odds ratio for death was 4.36 (95% confidence interval 2.83-6.71) and for stage 2 plus 3; 21.5 (12.0-38.6) compared to patients without acute kidney injury. Corresponding OR for stroke were 2.34 (1.43-3.82) and 6.52 (2.97-14.3) and for mediastinitis 2.88 (1.84-4.50) and 4.68 (2.07-10.6), respectively.


CONCLUSIONS
Acute kidney injury following coronary artery bypass grafting is related to postoperative mortality, stroke, and mediastinitis. Patients undergoing coronary artery bypass grafting should be assessed for presence of acute kidney injury postoperatively, in order to predict early prognosis.
Department of Emergency Medicine, Karolinska University Hospital Solna, Stockholm, Sweden. Linda.Ryden-Lujan@karolinska.se
Linda
L
Rydén
Staffan
S
Ahnve
Max
M
Bell
Niklas
N
Hammar
Torbjörn
T
Ivert
Martin J
MJ
Holzmann
D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000401:mortality; D000368:Aged; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology; D016017:Odds Ratio; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D016019:Survival Analysis; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
D003404:Creatinine