Analysis Of Incidence And Risk Factors Of Perioperative Acute Kidney Injury After Cardiac Surgery In Adults

Purpose: To explore the risk factors of acute renal injury(AKI)after cardiac surgery in intensive care unit(ICU)in order to find out the measures to improve the prognosis of patients.Methods: A total of 425 adult patients who were admitted to our hospital and underwent cardiac surgery on January 1,2018 and January 1,2019 were selected.Patients who met the study criteria were recorded into the required data:gender,age,Body Mass Index(BMI,Body Mass Index),smoking history,past medical history of hypertension,always with and without diabetes mellitus,preoperative creatinine,intraoperative extracorporeal circulation time,intraoperative urinary volume and postoperative creatinine,24-hour urine volume,postoperative hospitalization days,ICU admission days,postoperative 24 hours for tube drawing,total cost,end.According to the grading standard of KDIGO guidelines,patients were divided into AKI group and non AKI group,and data were analyzed respectively 23.0 the data of the two groups were compared and analyzed.The measurement data of all normal distribution were expressed in the form of mean ± standard deviation,and test was used;the dose data of non normal distribution was expressed in the form of median;the count data was expressed in the form of proportion,and non parameter test was used.In order to determine the risk factors of acute renal injury in ICU,the variables with statistical differences confirmed by single factor analysis were introduced into multi factor Logistic regression analysis model.Result: After screening in this study,a total of 425 adult heart surgery patients who met the inclusion criteria were included.Among the included patients,the number of adult patients with AKI after cardiac surgery was 139,and the incidence of AKI in this center was 32.71%.In this study,according to the KDIGO diagnostic criteria,among the patients with AKI in this center,86(61.87%)were stage 1 patients,28(20.14%)were stage 2 patients,and 25(17.99%)were stage 3 patients.According to the types of cardiac surgery in adults,patients with aortic dissection in this center have the highest incidence of AKI,followed by coronary bypass surgery,heart valve surgery,heart tumor surgery and other types of surgery.A total of 11 patients(2.59%)who were included in the study in this center ended up dying,and the mortality rate of AKI group was significantly higher than that of non-aki group.After regression analysis,it was found that the risk factors of AKI in ICU included: male,older,with hypertension,higher preoperative creatinine,and intraoperative cardiopulmonary bypass time.Conclusions: The incidence rate of acute kidney injury after cardiac surgery in ICU is high.It not only brings more pain to patients,but also increases their economic pressure.The retrospective study found that the incidence of AKI after cardiac surgery in ICU was related to a variety of risk factors,which needed special attention of medical staff.