Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;13(3):1728-1736.
doi: 10.21037/jtd-20-3205.

Serum creatinine as a predictor of mortality in patients readmitted to the intensive care unit after cardiac surgery: a retrospective cohort study in China

Jun Zhong  1 , Jian Gao  2 , Jing-Chao Luo  3 , Ji-Li Zheng  1 , Guo-Wei Tu  3 , Yan Xue  1
Affiliations

Serum creatinine as a predictor of mortality in patients readmitted to the intensive care unit after cardiac surgery: a retrospective cohort study in China

Jun Zhong et al. J Thorac Dis. 2021 Mar.

Abstract

Background: Patients readmitted to the intensive care unit (ICU) after cardiac surgery have a high mortality rate. The relationship between renal function and in-hospital mortality in readmitted patients has not been well demonstrated.

Methods: We retrospectively evaluated cardiac surgery patients who were readmitted to the ICU at least once. Data on serum creatinine levels before surgery and on the day of ICU readmission were collected. The estimated glomerular filtration rate (eGFR) was calculated according to the creatinine-based Chronic Kidney Disease-Epidemiology Collaboration equation. We used logistic regression models and restricted cubic spline curves with four knots (5%, 35%, 65%, 95%) to investigate the relationship between renal function indicators and mortality.

Results: Of the 184 patients evaluated, 30 patients died during hospitalization, yielding a mortality rate of 16.30%. Cardiac dysfunction (n=84, 45.65%) and respiration disorder (n=51, 27.72%) were the most common reasons for ICU readmission. Creatinine [odds ratio (OR): 1.14, 95% confidence interval (CI): 1.07-1.25] and eGFR (OR: 0.95, 95% CI: 0.93-0.98) were independently associated with in-hospital mortality after adjusting for various confounders. Both creatinine level and eGFR had a linear association with in-hospital mortality (P for non-linearity ˃0.05).

Conclusion: Renal function is significantly associated with the in-hospital mortality of patients readmitted to the ICU after cardiac surgery, as evidenced by the independent correlation of both creatinine and eGFR with in-hospital mortality.

Keywords: Readmission; cardiac surgery; intensive care unit (ICU); mortality; serum creatinine (SCR).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-3205). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Relationship between renal function indicators and log odds ratio (OR) of death after controlling for potential confounding variables (multivariable OR, 95% confidence intervals, and P value are shown). SCR, serum creatinine; eGFR, estimated glomerular filtration rate.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Curiel-Balsera E, Mora-Ordonez JM, Castillo-Lorente E, et al. Mortality and complications in elderly patients undergoing cardiac surgery. J Crit Care 2013;28:397-404. 10.1016/j.jcrc.2012.12.011 - DOI - PubMed
    1. Funkat AK, Beckmann A, Lewandowski J, et al. Cardiac surgery in Germany during 2011: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg 2012;60:371-82. 10.1055/s-0032-1326724 - DOI - PubMed
    1. Smilowitz NR, Berger JS. Perioperative Management to Reduce Cardiovascular Events. Circulation 2016;133:1125-30. 10.1161/CIRCULATIONAHA.115.017787 - DOI - PMC - PubMed
    1. Weiser TG, Haynes AB, Molina G, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet 2015;385 Suppl 2:S11. 10.1016/S0140-6736(15)60806-6 - DOI - PubMed
    1. Bardell T, Legare JF, Buth KJ, et al. ICU readmission after cardiac surgery. Eur J Cardiothorac Surg 2003;23:354-9. 10.1016/s1010-7940(02)00767-4 - DOI - PubMed