title: Clinical SYNTAX Score Can Predict Acute Kidney Injury following On-Pump but Not Off-Pump Coronary Artery Bypass Surgery.
abstract: BACKGROUND
  The complexity of coronary artery disease is usually a neglected factor in risk stratification systems. We aimed to analyze the discriminative ability of the clinical SYNTAX score (CSS) for acute kidney injury (AKI) following on- and off-pump coronary artery surgery.
  
  
  METHODS
  A total of 193 patients were reviewed in this study. Patients were divided into two groups according to the surgical procedure (group I: off-pump coronary artery bypass grafting, n = 89; group II: on-pump coronary artery bypass grafting, n = 104). Preoperative demographic data, the CSS and postoperative renal functions were evaluated. The postoperative AKI classification was made using the RIFLE (Risk, Injury, Failure, Loss of function, and End-stage renal disease) criteria.
  
  
  RESULTS
  Postoperative AKI occurred in 14 of 89 patients (15.7%) in group I and in 29 of 104 patients in group II (27.8%; p = 0.046). The CSS did not vary much between the groups (31.52 ± 13.08 vs. 29.89 ± 15.70; p = 0.638). In group I, the CSS was not different between patients with AKI and those without AKI (30.167 ± 3.93 vs. 31.91± 14.75; p = 0.78). In group II, the CSS was 36.85 ± 18.33 in patients with AKI and 28.02 ± 12.32 in those without, and the difference was significant (p = 0.02). The discriminative ability of the CSS for postoperative AKI using the AUC analysis was 0.500 in group I and 0.840 in group II.
  
  
  CONCLUSIONS
  The CSS may be a simple and successful means of risk prediction of postoperative AKI in on-pump coronary artery surgery.
authors.affiliation: Department of Cardiovascular Surgery, Istanbul, Turkey.
authors.forename: Mete
authors.initials: M
authors.lastname: Gursoy
authors.affiliation: Department of Cardiovascular Surgery, Istanbul, Turkey.
authors.forename: Abdulkadir Faruk
authors.initials: AF
authors.lastname: Hokenek
authors.affiliation: Department of Cardiology, Acibadem International Hospital, Istanbul, Turkey.
authors.forename: Egemen
authors.initials: E
authors.lastname: Duygu
authors.affiliation: Department of Cardiovascular Surgery, Karaman State Hospital, Karaman, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Atay
authors.affiliation: Department of Nephrology, Acibadem University, Istanbul, Turkey.
authors.forename: Asuman
authors.initials: A
authors.lastname: Yavuz
keywords: Acute kidney injury; Clinical SYNTAX score; Coronary bypass; Off-pump coronary artery bypass grafting; RIFLE criteria