Stage 1 acute kidney injury is independently associated with infection following cardiac surgery

Benjamin R Griffin; J Pedro Teixeira; Sophia Ambruso; Michael Bronsert; Jay D Pal; Joseph C Cleveland; T Brett Reece; David A Fullerton; Sarah Faubel; Muhammad Aftab

doi:10.1016/j.jtcvs.2019.11.004

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Stage 1 acute kidney injury is independently associated with infection following cardiac surgery

Journal article

Open access

Peer reviewed

Stage 1 acute kidney injury is independently associated with infection following cardiac surgery

Benjamin R Griffin, J Pedro Teixeira, Sophia Ambruso, Michael Bronsert, Jay D Pal, Joseph C Cleveland, T Brett Reece, David A Fullerton, Sarah Faubel and Muhammad Aftab

The Journal of thoracic and cardiovascular surgery, Vol.161(4), pp.1346-1355.e3

04/2021

DOI: 10.1016/j.jtcvs.2019.11.004

PMCID: PMC7285820

PMID: 32007252

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Abstract

Severe acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality. In this retrospective propensity score-matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS). Stage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P < .001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71-3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45). Stage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity.

Acute Kidney Injury - complications

Acute Kidney Injury - epidemiology

Aged

Cardiac Surgical Procedures - adverse effects

Female

Humans

Infections - complications

Infections - epidemiology

Length of Stay - statistics & numerical data

Male

Middle Aged

Postoperative Complications - epidemiology

Propensity Score

Retrospective Studies

Stroke - epidemiology

Details

Title: Subtitle: Stage 1 acute kidney injury is independently associated with infection following cardiac surgery
Creators: Benjamin R Griffin - University of Colorado Anschutz Medical Campus
J Pedro Teixeira - Washington University in St. Louis
Sophia Ambruso - University of Colorado Anschutz Medical Campus
Michael Bronsert - Outcomes Research Consortium
Jay D Pal - University of Colorado Denver
Joseph C Cleveland - University of Colorado Denver
T Brett Reece - University of Colorado Denver
David A Fullerton - University of Colorado Denver
Sarah Faubel - University of Colorado Anschutz Medical Campus
Muhammad Aftab
Resource Type: Journal article
Publication Details: The Journal of thoracic and cardiovascular surgery, Vol.161(4), pp.1346-1355.e3
DOI: 10.1016/j.jtcvs.2019.11.004
PMID: 32007252
PMCID: PMC7285820
ISSN: 0022-5223
eISSN: 1097-685X
Grant note: T32 DK007135 / NIDDK NIH HHS
Language: English
Date published: 04/2021
Academic Unit: Nephrology; Internal Medicine
Record Identifier: 9984359763202771

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