Stage 1 acute kidney injury is independently associated with infection following cardiac surgery

Severe acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality. In...

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Published in:	The Journal of thoracic and cardiovascular surgery 2021-04, Vol.161 (4), p.1346-1355.e3
Main Authors:	Griffin, Benjamin R., Teixeira, J. Pedro, Ambruso, Sophia, Bronsert, Michael, Pal, Jay D., Cleveland, Joseph C., Reece, T. Brett, Fullerton, David A., Faubel, Sarah, Aftab, Muhammad
Format:	Article
Language:	eng
Subjects:	acute kidney injury Acute Kidney Injury - complications Acute Kidney Injury - epidemiology Aged cardiac surgery Cardiac Surgical Procedures - adverse effects cardiopulmonary bypass Female Humans Infections - complications Infections - epidemiology Length of Stay - statistics & numerical data Male Middle Aged postoperative complications Postoperative Complications - epidemiology postoperative infection Propensity Score propensity-score matching Retrospective Studies Stroke - epidemiology
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Summary:	Severe acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality. In this retrospective propensity score–matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS). Stage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P
ISSN:	0022-5223 1097-685X