Long-Term Survival in Patients With Acute Kidney Injury After Acute Type A Aortic Dissection Repair
Background Although acute kidney injury (AKI) is known as a serious complication after operation for acute type A aortic dissection (AAAD), the long-term impact of AKI remains unclear. The aim of the present study is to investigate the long-term survival in patients with AKI after operation for AAAD...
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| Veröffentlicht in: | The Annals of thoracic surgery 2016-12, Vol.102 (6), p.2003-2009 |
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| creator | Sasabuchi, Yusuke, MD, MPH Kimura, Naoyuki, MD, PhD Shiotsuka, Junji, MD Komuro, Tetsuya, MD Mouri, Hideyuki, MD Ohnuma, Tetsu, MD Asaka, Kayo, MD Lefor, Alan K., MD, PhD Yasunaga, Hideo, MD, PhD Yamaguchi, Atsushi, MD, PhD Adachi, Hideo, MD, PhD Sanui, Masamitsu, MD, PhD |
| description | Background Although acute kidney injury (AKI) is known as a serious complication after operation for acute type A aortic dissection (AAAD), the long-term impact of AKI remains unclear. The aim of the present study is to investigate the long-term survival in patients with AKI after operation for AAAD. Methods This study included 403 patients who underwent operation for AAAD from 1990 to 2011 at Jichi Medical University, Saitama Medical Center. Postoperative AKI was identified according to the Kidney Disease Improving Global Outcomes criteria. Kaplan-Meier survival analysis and Cox proportional hazards regression were modeled to analyze the association between the AKI stage and postoperative long-term survival. Results Of 403 patients, 181 (44.9%) experienced postoperative AKI. Kaplan-Meier estimates for long-term survival were significantly different among patients without AKI and patients with stage 1, 2, and 3 AKI ( p |
| doi_str_mv | 10.1016/j.athoracsur.2016.05.006 |
| format | Article |
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The aim of the present study is to investigate the long-term survival in patients with AKI after operation for AAAD. Methods This study included 403 patients who underwent operation for AAAD from 1990 to 2011 at Jichi Medical University, Saitama Medical Center. Postoperative AKI was identified according to the Kidney Disease Improving Global Outcomes criteria. Kaplan-Meier survival analysis and Cox proportional hazards regression were modeled to analyze the association between the AKI stage and postoperative long-term survival. Results Of 403 patients, 181 (44.9%) experienced postoperative AKI. Kaplan-Meier estimates for long-term survival were significantly different among patients without AKI and patients with stage 1, 2, and 3 AKI ( p < 0.001). Hazard ratios of long-term survival for patients with stages 1, 2, and 3 AKI compared with patients without AKI were 1.38 (95% confidence interval [CI]: 0.84 to 2.26), 1.82 (95% CI: 0.95 to 3.51), and 3.79 (95% CI: 1.95 to 7.37), respectively. More patients with AKI died because of cardiovascular disease after discharge than patients without AKI (1.8% versus 6.0%, p = 0.03). Conclusions Stage 3 AKI is significantly associated with lower long-term survival after operation for AAAD. Patient follow-up after discharge that focuses on cardiovascular issues may benefit patients who survive AKI after AAAD operation.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2016.05.006</identifier><identifier>PMID: 27372373</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Acute Kidney Injury - etiology ; Acute Kidney Injury - mortality ; Aged ; Aneurysm, Dissecting - surgery ; Aortic Aneurysm, Thoracic - surgery ; Cardiothoracic Surgery ; Cause of Death ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Japan - epidemiology ; Kaplan-Meier Estimate ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Proportional Hazards Models ; Respiration, Artificial - utilization ; Retrospective Studies ; Risk Factors ; Surgery</subject><ispartof>The Annals of thoracic surgery, 2016-12, Vol.102 (6), p.2003-2009</ispartof><rights>The Society of Thoracic Surgeons</rights><rights>2016 The Society of Thoracic Surgeons</rights><rights>Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-58b8625aa4b234c30ae732c938f563150857b3aed4850a92ed26887a523c59a33</citedby><cites>FETCH-LOGICAL-c479t-58b8625aa4b234c30ae732c938f563150857b3aed4850a92ed26887a523c59a33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003497516304854$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27372373$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sasabuchi, Yusuke, MD, MPH</creatorcontrib><creatorcontrib>Kimura, Naoyuki, MD, PhD</creatorcontrib><creatorcontrib>Shiotsuka, Junji, MD</creatorcontrib><creatorcontrib>Komuro, Tetsuya, MD</creatorcontrib><creatorcontrib>Mouri, Hideyuki, MD</creatorcontrib><creatorcontrib>Ohnuma, Tetsu, MD</creatorcontrib><creatorcontrib>Asaka, Kayo, MD</creatorcontrib><creatorcontrib>Lefor, Alan K., MD, PhD</creatorcontrib><creatorcontrib>Yasunaga, Hideo, MD, PhD</creatorcontrib><creatorcontrib>Yamaguchi, Atsushi, MD, PhD</creatorcontrib><creatorcontrib>Adachi, Hideo, MD, PhD</creatorcontrib><creatorcontrib>Sanui, Masamitsu, MD, PhD</creatorcontrib><title>Long-Term Survival in Patients With Acute Kidney Injury After Acute Type A Aortic Dissection Repair</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background Although acute kidney injury (AKI) is known as a serious complication after operation for acute type A aortic dissection (AAAD), the long-term impact of AKI remains unclear. The aim of the present study is to investigate the long-term survival in patients with AKI after operation for AAAD. Methods This study included 403 patients who underwent operation for AAAD from 1990 to 2011 at Jichi Medical University, Saitama Medical Center. Postoperative AKI was identified according to the Kidney Disease Improving Global Outcomes criteria. Kaplan-Meier survival analysis and Cox proportional hazards regression were modeled to analyze the association between the AKI stage and postoperative long-term survival. Results Of 403 patients, 181 (44.9%) experienced postoperative AKI. Kaplan-Meier estimates for long-term survival were significantly different among patients without AKI and patients with stage 1, 2, and 3 AKI ( p < 0.001). Hazard ratios of long-term survival for patients with stages 1, 2, and 3 AKI compared with patients without AKI were 1.38 (95% confidence interval [CI]: 0.84 to 2.26), 1.82 (95% CI: 0.95 to 3.51), and 3.79 (95% CI: 1.95 to 7.37), respectively. More patients with AKI died because of cardiovascular disease after discharge than patients without AKI (1.8% versus 6.0%, p = 0.03). Conclusions Stage 3 AKI is significantly associated with lower long-term survival after operation for AAAD. Patient follow-up after discharge that focuses on cardiovascular issues may benefit patients who survive AKI after AAAD operation.</description><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - mortality</subject><subject>Aged</subject><subject>Aneurysm, Dissecting - surgery</subject><subject>Aortic Aneurysm, Thoracic - surgery</subject><subject>Cardiothoracic Surgery</subject><subject>Cause of Death</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Kaplan-Meier Estimate</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Proportional Hazards Models</subject><subject>Respiration, Artificial - utilization</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU2P0zAQhi0EYruFv4B85JLg2HHsXJDCssuuqLSILeJouc6UdUjtYjuV8u_XVQtInDhZ43nf-XgGIVyRsiJV824odXr0QZs4hZLmn5LwkpDmGVpUnNOiobx9jhaEEFbUreAX6DLGIYc0p1-iCyqYoEywBTIr734Uawg7_DCFgz3oEVuHv-hkwaWIv9v0iDszJcCfbe9gxndumMKMu22CcM6s5z3gDnc-JGvwRxsjmGS9w19hr214hV5s9Rjh9fldom831-ur22J1_-nuqlsVphZtKrjcyDy41vWGstowokEwalomt7xhFSeSiw3T0NeSE91S6GkjpdCcMsNbzdgSvT3V3Qf_a4KY1M5GA-OoHfgpqkrSRmQA2bBE8iQ1wccYYKv2we50mFVF1BGxGtRfxOqIWBGuMuJsfXPuMm120P8x_maaBR9OAsi7HiwEFU2GaaC3IXNRvbf_0-X9P0XMaJ01evwJM8TBT8FllqpSkSqiHo6nPl66ahjJfGr2BEPopfY</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Sasabuchi, Yusuke, MD, MPH</creator><creator>Kimura, Naoyuki, MD, PhD</creator><creator>Shiotsuka, Junji, MD</creator><creator>Komuro, Tetsuya, MD</creator><creator>Mouri, Hideyuki, MD</creator><creator>Ohnuma, Tetsu, MD</creator><creator>Asaka, Kayo, MD</creator><creator>Lefor, Alan K., MD, PhD</creator><creator>Yasunaga, Hideo, MD, PhD</creator><creator>Yamaguchi, Atsushi, MD, PhD</creator><creator>Adachi, Hideo, MD, PhD</creator><creator>Sanui, Masamitsu, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161201</creationdate><title>Long-Term Survival in Patients With Acute Kidney Injury After Acute Type A Aortic Dissection Repair</title><author>Sasabuchi, Yusuke, MD, MPH ; Kimura, Naoyuki, MD, PhD ; Shiotsuka, Junji, MD ; Komuro, Tetsuya, MD ; Mouri, Hideyuki, MD ; Ohnuma, Tetsu, MD ; Asaka, Kayo, MD ; Lefor, Alan K., MD, PhD ; Yasunaga, Hideo, MD, PhD ; Yamaguchi, Atsushi, MD, PhD ; Adachi, Hideo, MD, PhD ; Sanui, Masamitsu, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-58b8625aa4b234c30ae732c938f563150857b3aed4850a92ed26887a523c59a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - mortality</topic><topic>Aged</topic><topic>Aneurysm, Dissecting - surgery</topic><topic>Aortic Aneurysm, Thoracic - surgery</topic><topic>Cardiothoracic Surgery</topic><topic>Cause of Death</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Kaplan-Meier Estimate</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Proportional Hazards Models</topic><topic>Respiration, Artificial - utilization</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sasabuchi, Yusuke, MD, MPH</creatorcontrib><creatorcontrib>Kimura, Naoyuki, MD, PhD</creatorcontrib><creatorcontrib>Shiotsuka, Junji, MD</creatorcontrib><creatorcontrib>Komuro, Tetsuya, MD</creatorcontrib><creatorcontrib>Mouri, Hideyuki, MD</creatorcontrib><creatorcontrib>Ohnuma, Tetsu, MD</creatorcontrib><creatorcontrib>Asaka, Kayo, MD</creatorcontrib><creatorcontrib>Lefor, Alan K., MD, PhD</creatorcontrib><creatorcontrib>Yasunaga, Hideo, MD, PhD</creatorcontrib><creatorcontrib>Yamaguchi, Atsushi, MD, PhD</creatorcontrib><creatorcontrib>Adachi, Hideo, MD, PhD</creatorcontrib><creatorcontrib>Sanui, Masamitsu, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sasabuchi, Yusuke, MD, MPH</au><au>Kimura, Naoyuki, MD, PhD</au><au>Shiotsuka, Junji, MD</au><au>Komuro, Tetsuya, MD</au><au>Mouri, Hideyuki, MD</au><au>Ohnuma, Tetsu, MD</au><au>Asaka, Kayo, MD</au><au>Lefor, Alan K., MD, PhD</au><au>Yasunaga, Hideo, MD, PhD</au><au>Yamaguchi, Atsushi, MD, PhD</au><au>Adachi, Hideo, MD, PhD</au><au>Sanui, Masamitsu, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Survival in Patients With Acute Kidney Injury After Acute Type A Aortic Dissection Repair</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>102</volume><issue>6</issue><spage>2003</spage><epage>2009</epage><pages>2003-2009</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>Background Although acute kidney injury (AKI) is known as a serious complication after operation for acute type A aortic dissection (AAAD), the long-term impact of AKI remains unclear. The aim of the present study is to investigate the long-term survival in patients with AKI after operation for AAAD. Methods This study included 403 patients who underwent operation for AAAD from 1990 to 2011 at Jichi Medical University, Saitama Medical Center. Postoperative AKI was identified according to the Kidney Disease Improving Global Outcomes criteria. Kaplan-Meier survival analysis and Cox proportional hazards regression were modeled to analyze the association between the AKI stage and postoperative long-term survival. Results Of 403 patients, 181 (44.9%) experienced postoperative AKI. Kaplan-Meier estimates for long-term survival were significantly different among patients without AKI and patients with stage 1, 2, and 3 AKI ( p < 0.001). Hazard ratios of long-term survival for patients with stages 1, 2, and 3 AKI compared with patients without AKI were 1.38 (95% confidence interval [CI]: 0.84 to 2.26), 1.82 (95% CI: 0.95 to 3.51), and 3.79 (95% CI: 1.95 to 7.37), respectively. More patients with AKI died because of cardiovascular disease after discharge than patients without AKI (1.8% versus 6.0%, p = 0.03). Conclusions Stage 3 AKI is significantly associated with lower long-term survival after operation for AAAD. Patient follow-up after discharge that focuses on cardiovascular issues may benefit patients who survive AKI after AAAD operation.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>27372373</pmid><doi>10.1016/j.athoracsur.2016.05.006</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Kidney Injury - etiology Acute Kidney Injury - mortality Aged Aneurysm, Dissecting - surgery Aortic Aneurysm, Thoracic - surgery Cardiothoracic Surgery Cause of Death Comorbidity Female Follow-Up Studies Humans Japan - epidemiology Kaplan-Meier Estimate Length of Stay - statistics & numerical data Male Middle Aged Postoperative Complications - etiology Postoperative Complications - mortality Proportional Hazards Models Respiration, Artificial - utilization Retrospective Studies Risk Factors Surgery |
| title | Long-Term Survival in Patients With Acute Kidney Injury After Acute Type A Aortic Dissection Repair |
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