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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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| Published in: | PloS one 2017-02, Vol.12 (2), p.e0172021-e0172021 |
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| creator | Duque-Sosa, Paula Martínez-Urbistondo, Diego Echarri, Gemma Callejas, Raquel Iribarren, María Josefa Rábago, Gregorio Monedero, Pablo |
| description | 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 |
| doi_str_mv | 10.1371/journal.pone.0172021 |
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Results from a Spanish multicenter retrospective cohort study</title><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Duque-Sosa, Paula ; Martínez-Urbistondo, Diego ; Echarri, Gemma ; Callejas, Raquel ; Iribarren, María Josefa ; Rábago, Gregorio ; Monedero, Pablo</creator><contributor>Burdmann, Emmanuel A</contributor><creatorcontrib>Duque-Sosa, Paula ; Martínez-Urbistondo, Diego ; Echarri, Gemma ; Callejas, Raquel ; Iribarren, María Josefa ; Rábago, Gregorio ; Monedero, Pablo ; Spanish group of renal dysfunction in cardiac surgery (GEDRCC-2) ; Burdmann, Emmanuel A</creatorcontrib><description>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 <19 g/dL was an independent risk factor for CSA-AKI even after adjustment for intraoperative red blood cell transfusion (OR 1.41, p <0.05). It was also associated with mortality (OR 2.48, p <0.01) and prolonged hospital length of stay (4.67 ± 0.99 days, p <0.001).</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0172021</identifier><identifier>PMID: 28225801</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2017-02, Vol.12 (2), p.e0172021-e0172021</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Duque-Sosa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Duque-Sosa et al 2017 Duque-Sosa et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-c10b1dbe25e4d1774e5beb7c4f9d61a736a98c9f96047dcd25a2ef720ebb264c3</citedby><cites>FETCH-LOGICAL-c725t-c10b1dbe25e4d1774e5beb7c4f9d61a736a98c9f96047dcd25a2ef720ebb264c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1870938084/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1870938084?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,730,783,787,888,25765,27936,27937,37024,37025,44602,53804,53806,75460</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28225801$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Burdmann, Emmanuel A</contributor><creatorcontrib>Duque-Sosa, Paula</creatorcontrib><creatorcontrib>Martínez-Urbistondo, Diego</creatorcontrib><creatorcontrib>Echarri, Gemma</creatorcontrib><creatorcontrib>Callejas, Raquel</creatorcontrib><creatorcontrib>Iribarren, María Josefa</creatorcontrib><creatorcontrib>Rábago, Gregorio</creatorcontrib><creatorcontrib>Monedero, Pablo</creatorcontrib><creatorcontrib>Spanish group of renal dysfunction in cardiac surgery (GEDRCC-2)</creatorcontrib><title>Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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 <19 g/dL was an independent risk factor for CSA-AKI even after adjustment for intraoperative red blood cell transfusion (OR 1.41, p <0.05). It was also associated with mortality (OR 2.48, p <0.01) and prolonged hospital length of stay (4.67 ± 0.99 days, p <0.001).</description><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - diagnosis</subject><subject>Acute Kidney Injury - etiology</subject><subject>Aged</subject><subject>Analysis</subject><subject>Anemia</subject><subject>Anesthesiology</subject><subject>Area Under Curve</subject><subject>Biology and Life Sciences</subject><subject>Bleeding</subject><subject>Blood</subject><subject>Blood transfusion</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiovascular disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Complications and side effects</subject><subject>Coronary artery bypass</subject><subject>Creatinine</subject><subject>Critical care</subject><subject>Erythrocytes</subject><subject>Family medical history</subject><subject>Female</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart surgery</subject><subject>Hemoglobin</subject><subject>Hemoglobins - 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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 <19 g/dL was an independent risk factor for CSA-AKI even after adjustment for intraoperative red blood cell transfusion (OR 1.41, p <0.05). It was also associated with mortality (OR 2.48, p <0.01) and prolonged hospital length of stay (4.67 ± 0.99 days, p <0.001).</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28225801</pmid><doi>10.1371/journal.pone.0172021</doi><tpages>e0172021</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-02, Vol.12 (2), p.e0172021-e0172021 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1870938084 |
| source | Publicly Available Content Database; PubMed Central |
| 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 |
| title | Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-11-13T13%3A11%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Perioperative%20hemoglobin%20area%20under%20the%20curve%20is%20an%20independent%20predictor%20of%20renal%20failure%20after%20cardiac%20surgery.%20Results%20from%20a%20Spanish%20multicenter%20retrospective%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Duque-Sosa,%20Paula&rft.aucorp=Spanish%20group%20of%20renal%20dysfunction%20in%20cardiac%20surgery%20(GEDRCC-2)&rft.date=2017-02-22&rft.volume=12&rft.issue=2&rft.spage=e0172021&rft.epage=e0172021&rft.pages=e0172021-e0172021&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0172021&rft_dat=%3Cgale_plos_%3EA482147829%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c725t-c10b1dbe25e4d1774e5beb7c4f9d61a736a98c9f96047dcd25a2ef720ebb264c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1870938084&rft_id=info:pmid/28225801&rft_galeid=A482147829&rfr_iscdi=true |