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Review
. 2024 Oct 21;13(4):e00314.
doi: 10.1097/XCE.0000000000000314. eCollection 2024 Dec.

Development of acute kidney injury following repair of Stanford type A aortic dissection is associated with increased mortality and complications: a systematic review, meta-analysis, and meta-regression analysis

Aman Goyal  1 , Surabhi Maheshwari  2 , Haleema Qayyum Abbasi  3 , Yusra Mashkoor  4 , Urooj Shamim  5 , Mahla Chambari  6 , Arjun Kelaiya  7 , Darsh Safi  1 , Humza Saeed  8 , Hritvik Jain  9 , Prakriti Pokhrel  10 , Irfan Ullah  11
Affiliations
Review

Development of acute kidney injury following repair of Stanford type A aortic dissection is associated with increased mortality and complications: a systematic review, meta-analysis, and meta-regression analysis

Aman Goyal et al. Cardiovasc Endocrinol Metab. .

Abstract

Acute kidney injury (AKI) frequently complicates the repair of Stanford type A aortic dissection (TAAD). This systematic review, meta-analysis, and meta-regression analysis aimed to elucidate the prognostic impact of AKI in these patients. A literature search in PubMed, EMBASE, and Google Scholar identified relevant studies on the predictors and outcomes of AKI following TAAD repair. The primary endpoint was 30-day mortality; secondary endpoints included stroke, dialysis/continuous renal replacement therapy (CRRT), and other complications. Random-effects meta-analyses were used, with significance set at P < 0.05. Twenty-one studies (10 396 patients) were analyzed. AKI was associated with higher risks of 30-day mortality (risk ratio = 3.98), stroke (risk ratio = 2.05), dialysis/CRRT (risk ratio = 32.91), cardiovascular (risk ratio = 2.85) and respiratory complications (risk ratio = 2.13), sepsis (risk ratio = 4.92), and re-exploration for bleeding (risk ratio = 2.46). No significant differences were noted in sternal wound infection, tracheostomy, paraplegia, or hepatic failure. AKI significantly increases mortality, morbidity, hospital, and ICU stay duration in TAAD repair patients.

Keywords: acute kidney injury; aortic dissection; cardiology; meta-analysis; mortality; prevention.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow Diagram (2020) for systematic reviews and meta-analyses.
Fig. 2
Fig. 2
Forest plot for the outcome of 30-day mortality.
Fig. 3
Fig. 3
Forest plots for the outcome of (a) stroke and (b) the need for dialysis/CRRT. CRRT, continuous renal replacement therapy.
Fig. 4
Fig. 4
Forest plots for the outcomes of (a) cardiovascular complications, (b) respiratory complications, and (c) sepsis.
Fig. 5
Fig. 5
Forest plots for the outcomes of (a) reexploration for bleeding, (b) sternal wound infection, and (c) the need for tracheostomy.
Fig. 6
Fig. 6
Forest plots for the outcomes of (a) paraplegia, (b) hepatic failure, (c) lengths of stay in hospital, and (d) lengths of stay in ICU.
See this image and copyright information in PMC

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