Incidence, Risk Factors, and Risk Model of Acute Kidney Injury After Thoracic Aortic Surgery

Postoperative acute kidney injury (AKI) is still one of the serious complications of thoracic aortic surgery, with incidence of 8 to 50 percent. Postoperative AKI significantly increases the morbidity and mortality of patients undergoing thoracic aortic surgery. Previous studies for AKI after DHCA reported confounding results due to different criteria of AKI. Therefore, the investigators tried to evaluate the incidence and risk factors of AKI after thoracic aortic surgery according to the diagnostic criteria and staging system of AKI reported from acute kidney injury network. The investigators also tried to develop a risk model with scoring system of AKI and evaluate the performance of the risk model.

Study Overview

• Status: Completed
• Conditions: Thoracic Aortic Surgery
• Intervention / Treatment: Other: Electronic Medical Record (EMR) Review

Detailed Description

Significant improvement of morbidity and mortality has been achieved during last three decades since developing deep hypothermic circulatory arrest (DHCA). However,postoperative acute kidney injury (AKI) is still one of the serious complications of thoracic aortic surgery, with incidence of 8 to 50 percent. Postoperative AKI significantly increases the morbidity and mortality of patients undergoing thoracic aortic surgery. Previous studies for AKI after DHCA reported confounding results due to different criteria of AKI. Therefore, the investigators tried to evaluate the incidence and risk factors of AKI after thoracic aortic surgery according to the diagnostic criteria and staging system of AKI reported from acute kidney injury network (2007). The investigators also tried to develop a risk model with scoring system of AKI and evaluate the performance of the risk model.

• Study Type: Observational
• Enrollment (Actual): 799

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 135-710
    • Samsung Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients who underwent thoracic aortic surgery durung 1994 to 2010 period

Description

Inclusion Criteria:

• patients who underwent thoracic aortic surgery during 1994 to 2010 period

Exclusion Criteria:

• patients who had previous renal failure before aortic surgery

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

thoracic aortic surgery group; patients who underwent thoracic aortic surgery

Other: Electronic Medical Record (EMR) Review; measurements of potential risk factors of acute kidney injury through the patients' previous medical record review. potential risk factors include previous history of hypertension, diabetes, cerebrovascular events, peripheral arterial disease, chronic obstructive pulmonary disease, recent myocardial infarction, coronary artery disease; preoperative glomerular filtration rate, preoperative creatinine level, preoperative cardiac ejection fraction reported on echocardiography, use of preoperative inotropics, use of deep hypothermic cardiac arrest, intraoperative colloid use, intraoperative blood product transfusion, total time of cardiopulmonary bypass,; Other Names: Electronic Medical Record (EMR)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
presence of Acute kidney injury	diagnosis of AKI if the record of patient meet one of the below criteria; abrupt (within 48 hours) reduction in kidney function currently defined as; absolute increase in serum creatinine of more than or equal to 0.3 mg/dl (≥ 26.4 μmol/l),; a percentage increase in serum creatinine of more than or equal to 50% (1.5-fold from baseline), or; a reduction in urine output (documented oliguria of less than 0.5 ml/kg per hour for more than six hours)	1 time, within 48 hours of aortic surgery

Collaborators and Investigators

• Sponsor: Samsung Medical Center
• Investigators: Principal Investigator: Sangmin M. Lee, M.D.,Ph.D., Samsung Medical Center

Study record dates

Study Major Dates

• Study Start: July 1, 2011
• Primary Completion (Actual): September 1, 2012
• Study Completion (Actual): September 1, 2012

Study Registration Dates

• First Submitted: July 21, 2011
• First Submitted That Met QC Criteria: July 22, 2011
• First Posted (Estimate): July 25, 2011

Study Record Updates

• Last Update Posted (Estimate): December 25, 2013
• Last Update Submitted That Met QC Criteria: December 24, 2013
• Last Verified: December 1, 2013

More Information

Terms related to this study

• Keywords: acute kidney injury; thoracic aortic surgery
• Additional Relevant MeSH Terms: Kidney Diseases; Urologic Diseases; Renal Insufficiency; Acute Kidney Injury
• Other Study ID Numbers: 2011-06-077