Original articleAdult cardiacAcute Kidney Injury Severity and Long-Term Readmission and Mortality After Cardiac Surgery
Section snippets
Cohort, NNE Biomarker Study
Patients undergoing coronary artery bypass graft surgery or valve surgery at any of eight hospitals participating in the Northern New England Cardiovascular Disease Study Group (NNE) were prospectively enrolled in the NNE Biomarker Study from 2004 to 2007 (n = 1,690). For the present study, the sample was restricted to only those patients for whom coronary artery bypass graft surgery was the primary procedure (n = 1,610). Patients were excluded from the analysis if they had a history of renal
Results
Overall, 513 patients (33.8%) had AKI with AKIN stage 1 (29.9%) and stage 2 or 3 (3.9%). There were 620 readmissions (39.9%) and 370 deaths (23.8%) overall, and 620 readmissions (39.9%) readmissions and 192 deaths (12.3%) within 5 years. Patient characteristics and comorbidities are summarized in Table 1.
We stratified intraoperative and postoperative variables by AKIN stage in Table 2. Intraoperative factors differed by AKIN stage for intraaortic balloon pump, number of packed red blood cells,
Comment
Using AKIN stage criteria, our study confirms similar findings from the literature that AKI severity is associated with increased hospital readmission and mortality 10, 16. We discovered that AKIN stage 1 and stage 2 or 3 were associated with a significant 31% to 98% increased hazard of 5-year readmission. In addition, AKIN stage 1 and stage 2 or 3 were associated with a significant 1.5- to 3.5-fold increased hazard of 5-year mortality. Our findings suggest that current and novel therapeutic
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