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. 2024 Jul 5;24(1):224.
doi: 10.1186/s12871-024-02616-4.

The impact of intraoperative hypotension on postoperative acute kidney injury, mortality and length of stay following off-pump coronary artery bypass grafting surgery: a single-center retrospective cohort study

Cheng Xiao  1 , Ming Yang  1 , Lei Cao  1 , Fang Chen  1 , Sheng Jing  1 , Yuting Tan  1 , Hong Li  2
Affiliations

The impact of intraoperative hypotension on postoperative acute kidney injury, mortality and length of stay following off-pump coronary artery bypass grafting surgery: a single-center retrospective cohort study

Cheng Xiao et al. BMC Anesthesiol. .

Abstract

Background: Off-pump coronary artery bypass grafting (OPCABG) presents distinct hemodynamic characteristics, yet the relationship between intraoperative hypotension and short-term adverse outcomes remains clear. Our study aims to investigate association between intraoperative hypotension and postoperative acute kidney injury (AKI), mortality and length of stay in OPCABG patients.

Methods: Retrospective data of 494 patients underwent OPCABG from January 2016 to July 2023 were collected. We analyzed the relationship between intraoperative various hypotension absolute values (MAP > 75, 65 < MAP ≤ 75, 55 < MAP ≤ 65, MAP ≤ 55 mmHg) and postoperative AKI, mortality and length of stay. Logistic regression assessed the impacts of exposure variable on AKI and postoperative mortality. Linear regression was used to analyze risk factors on the length of intensive care unit stay (ICU) and hospital stay.

Results: The incidence of AKI was 31.8%, with in-hospital and 30-day mortality at 2.8% and 3.5%, respectively. Maintaining a MAP greater than or equal 65 mmHg [odds ratio (OR) 0.408; p = 0.008] and 75 mmHg (OR 0.479; p = 0.024) was significantly associated with a decrease risk of AKI compared to MAP less than 55 mmHg for at least 10 min. Prolonged hospital stays were linked to low MAP, while in-hospital mortality and 30-day mortality were not linked to IOH but exhibited correlation with a history of myocardial infarction. AKI showed correlation with length of ICU stay.

Conclusions: MAP > 65 mmHg emerges as a significant independent protective factor for AKI in OPCABG and IOH is related to length of hospital stay. Proactive intervention targeting intraoperative hypotension may provide a potential opportunity to reduce postoperative renal injury and hospital stay.

Trial registration: ChiCTR2400082518. Registered 31 March 2024. https://www.chictr.org.cn/bin/project/edit?pid=225349 .

Keywords: Acute kidney injury; Intraoperative hypotension; Length of stay; Mortality; Off-pump coronary artery bypass grafting.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study. OPCABG, off-pump coronary artery bypass grafting; eGFR, estimated glomerular filtration rate; CABG, coronary artery bypass grafting; AKI, acute kidney injury
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References

    1. Mortality GBD, Causes of Death C. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the global burden of Disease Study 2015. Lancet. 2016;388(10053):1459–544. doi: 10.1016/S0140-6736(16)31012-1. - DOI - PMC - PubMed
    1. Zhang P, Wang L, Zhai K, Huang J, Wang W, Ma Q, Liu D, Gao B, Li Y. Off-pump versus on-pump redo coronary artery bypass grafting: a systematic review and meta-analysis. Perfusion. 2021;36(7):724–36. doi: 10.1177/0267659120960310. - DOI - PubMed
    1. Gong H, Zhang T, Dong H, Lei C. Association of cardiopulmonary bypass with acute kidney injury in patients undergoing coronary artery bypass grafting: a retrospective cohort study. Chin Med J (Engl) 2023. - PMC - PubMed
    1. Keuffel EL, Rizzo J, Stevens M, Gunnarsson C, Maheshwari K. Hospital costs associated with intraoperative hypotension among non-cardiac surgical patients in the US: a simulation model. J Med Econ. 2019;22(7):645–51. doi: 10.1080/13696998.2019.1591147. - DOI - PubMed
    1. Sun LY, Wijeysundera DN, Tait GA, Beattie WS. Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology 2015, 123(3):515–23. - PubMed

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