Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study

Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introd...

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Bibliographic Details
Published in:PloS one 2017-02, Vol.12 (2), p.e0172021-e0172021
Main Authors: Duque-Sosa, Paula, Martínez-Urbistondo, Diego, Echarri, Gemma, Callejas, Raquel, Iribarren, María Josefa, Rábago, Gregorio, Monedero, Pablo
Format: Article
Language:English
Subjects:
Acute Kidney Injury - blood
Acute Kidney Injury - diagnosis
Acute Kidney Injury - etiology
Aged
Analysis
Anemia
Anesthesiology
Area Under Curve
Biology and Life Sciences
Bleeding
Blood
Blood transfusion
Cardiac Surgical Procedures - adverse effects
Cardiovascular disease
Chronic obstructive pulmonary disease
Cohort analysis
Complications and side effects
Coronary artery bypass
Creatinine
Critical care
Erythrocytes
Family medical history
Female
Health aspects
Heart
Heart diseases
Heart surgery
Hemoglobin
Hemoglobins - analysis
Humans
Intensive care
Kidney failure
Kidneys
Length of Stay
Male
Medicine and Health Sciences
Middle Aged
Mortality
Patients
Perioperative Period
Postoperative Complications - blood
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Predictive Value of Tests
Prognosis
Regression analysis
Renal failure
Renal Insufficiency - blood
Renal Insufficiency - diagnosis
Renal Insufficiency - etiology
Retrospective Studies
Risk Factors
Spain
Surgery
Transfusion
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Summary:Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain. Exclusion criteria were patients on renal replacement therapy, who needed a reoperation because of bleeding and/or with missing perioperative hemoglobin or creatinine values. Using a multivariate regression analysis, we found that a pHb-AUC
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0172021