No AKI | AKI | P1 Value* | P2 Value# | |||
---|---|---|---|---|---|---|
Stage 1 | Stage 2 | Stage 3 | ||||
Patient population (n) | 169 | 153 | 49 | 28 | ||
Demographic data | ||||||
Age (y) | 52.0 (18.0) | 54.0 (16.5) | 50.0 (13.0) | 41.5 (17.5) | 0.9 | 0.004 |
Sex, male (n) | 112 (66.3%) | 116 (75.8%) | 34 (69.4%) | 21 (75.0%) | 0.08 | 0.3 |
Height (cm) | 170.0 (13.0) | 170.0 (8.5) | 170.0 (14.0) | 169.0 (10.0) | 0.7 | 1.0 |
Weight (kg) | 70.0 (16.0) | 72.0 (18.0) | 74.0 (24.0) | 75.0 (20.0) | 0.002 | 0.02 |
BMI (kg/m2) | 24.6 (5.1) | 25.7 (5.8) | 25.2 (4.9) | 27.4 (5.8) | 0.003 | 0.009 |
Medical history | ||||||
Diabetes (n) | 4 (2.4%) | 4 (2.6%) | 3 (6.1%) | 1 (3.6%) | 0.5 | 0.6 |
Hypertension (n) | 74 (43.8%) | 85 (55.6%) | 34 (69.4%) | 23 (82.1%) | < 0.001 | < 0.001 |
Chronic obstructive pulmonary disease (n) | 4 (2.4%) | 6 (3.9%) | 1 (2.0%) | 0 (0.0%) | 0.7 | 0.6 |
Previous myocardial infarction (n) | 1 (0.6%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0.2 | 0.7 |
Peripheral vascular disease (n) | 13 (7.7%) | 11 (7.2%) | 5 (10.2%) | 1 (3.6%) | 0.9 | 0.8 |
Smoking (n) | 57 (33.7%) | 59 (38.6%) | 19 (38.8%) | 12 (42.9%) | 0.3 | 0.7 |
Preoperative laboratory tests | ||||||
Platelet (109/L) | 197.0 (71.0) | 186.5 (71.8) | 199.0 (65.5) | 166.5 (68.3) | 0.006 | 0.01 |
Lymphocyte (109/L) | 1.63 (0.74) | 1.58 (0.90) | 1.18 (0.72) | 1.48 (0.90) | 0.004 | 0.001 |
Monocyte (109/L) | 0.44 (0.30) | 0.51 (0.40) | 0.79 (0.78) | 0.91 (0.70) | < 0.001 | < 0.001 |
Neutrophil (109/L) | 4.22 (2.95) | 4.86 (4.30) | 7.51 (5.64) | 10.1 (5.3) | < 0.001 | < 0.001 |
Hyperlipidemia (n) | 55 (34.4%) | 44 (31.0%) | 7 (14.9%) | 10 (43.5%) | 0.2 | 0.04 |
Retinol binding protein (mg/L) | 35.7 (16.2) | 37.8 (18.7) | 26.4 (24.7) | 37.3 (22.5) | 0.7 | 0.007 |
Urinary protein | ||||||
+/− | 17 (11.6%) | 25 (18.8%) | 10 (23.8%) | 4 (20.0%) | 0.05 | 0.2 |
+ | 14 (9.5%) | 20 (15.0%) | 11 (26.2%) | 8 (40.0%) | 0.01 | 0.005 |
++ | 1 (0.7%) | 2 (1.5%) | 2 (4.8%) | 1 (5.0%) | 0.2 | 0.3 |
INR | 1.04 (0.12) | 1.04 (0.1) | 1.09 (0.15) | 1.10 (0.2) | 0.05 | 0.02 |
Preoperative renal function | ||||||
Preoperative SCr (μmol/L) | 70.4 (21.79) | 73.6 (23.1) | 66.0 (26.3) | 76.0 (45.7) | 0.3 | 0.07 |
> 106 (n) | 11 (6.5%) | 13 (8.5%) | 4 (8.2%) | 8 (28.6%) | 0.1 | 0.002 |
eGFR(mL/min/1.73 m2) | 99.8 (22.0) | 97.2 (21.2) | 103.4 (18.2) | 94.4 (39.5) | 0.2 | 0.08 |
Preoperative cardiovascular status | ||||||
Marfan syndrome (n) | 14 (8.3%) | 3 (2.0%) | 1 (2.0%) | 1 (3.6%) | 0.005 | 0.04 |
Aortic dissection (n) | 56 (33.1%) | 71 (46.4%) | 36 (73.5%) | 24 (85.7%) | < 0.001 | < 0.001 |
Stanford type-A aortic dissection (n) | 53 (31.4%) | 71 (46.4%) | 34 (69.4%) | 24 (85.7%) | < 0.001 | < 0.001 |
Intraoperative blood product use | ||||||
Erythrocytes (u) | 2.0 (2.0) | 4.0 (3.9) | 4.0 (6.0) | 4.0 (4.5) | 0.001 | < 0.001 |
Fresh frozen plasma (ml) | 400.0 (200.0) | 400.0 (150.0) | 400.0 (375.0) | 600.0 (500.0) | 0.06 | 0.002 |
Platelets (u) | 1.0 (0.0) | 1.0 (1.0) | 1.0 (1.0) | 2.0 (1.0) | 0.002 | < 0.001 |
Surgical details | ||||||
Involving the aortic arch (n) | 79 (46.7%) | 97 (63.4%) | 38 (77.6%) | 26 (92.9%) | < 0.001 | < 0.001 |
Involving the descending aorta (n) | 43 (25.4%) | 60 (39.2%) | 33 (67.3%) | 24 (85.7%) | < 0.001 | < 0.001 |
CPB duration(min) | 133.0 (75.5) | 165.0 (79.0) | 201.0 (67.5) | 220.0 (52.0) | < 0.001 | < 0.001 |
DHCA or MHCA (n) | 58 (34.3%) | 76 (49.7%) | 34 (69.4%) | 25 (89.3%) | < 0.001 | < 0.001 |
Aortic cross-clamp time (min) | 86.0 (27.0) | 90.0 (31.0) | 96.0 (32.0) | 113.0 (32.0) | < 0.001 | < 0.001 |
Operation time (h) | 6.0 (2.0) | 7.0 (2.0) | 8.5 (2.0) | 9.0 (2.5) | < 0.001 | < 0.001 |
Combined surgery | ||||||
Valvular surgery (n) | 94 (55.6%) | 67 (43.8%) | 10 (20.4%) | 3 (10.7%) | < 0.001 | < 0.001 |
Outcomes | ||||||
Renal replacement therapy (n) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 12 (42.9%) | 0.003 | < 0.001 |
Length of ICU stay (day) | 3.0 (2.0) | 4.0 (2.5) | 5.0 (4.0) | 10.5 (11.0) | < 0.001 | < 0.001 |
> 7 d (n) | 19 (11.2%) | 20 (13.1%) | 17 (34.7%) | 23 (82.1%) | < 0.001 | < 0.001 |
Intubation time (h) | 15.0 (9.0) | 17.0 (27.5) | 38.0 (72.5) | 136.0 (110.3) | < 0.001 | < 0.001 |
> 5 d (n) | 4 (2.4%) | 5 (3.3%) | 6 (12.2%) | 17 (60.7%) | < 0.001 | < 0.001 |
Stroke (n) | 0 (0.0%) | 4 (2.6%) | 0 (0.0%) | 2 (7.1%) | 0.04 | 0.01 |
Redo surgery (n) | 4 (2.4%) | 6 (3.9%) | 6 (12.2%) | 6 (21.4%) | 0.02 | < 0.001 |
In-hospital mortality (n) | 2 (1.2%) | 1 (0.7%) | 1 (2.1%) | 8 (28.6%) | 0.07 | < 0.001 |