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Renal Failure in Type A Aortic Dissection Repair: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis
Open accessAbstract
Background We sought to identify predictors of acute renal failure (ARF) after acute type A aortic dissection (ATAAD) and its implications for postoperative outcomes. Methods ATAAD cases were identified from The Society of Thoracic Surgeons Adult Cardiac Surgery Database (2017-2022). Cases with chronic dissection, prior aortic repair, primary endovascular repair, preoperative extracorporeal membrane oxygenation, preoperative renal failure, and operative room deaths were excluded. ARF was defined as either a 3-fold increase in creatinine concentration or creatinine concentration >4 mg/dL with an increment ≥0.5 mg/dL from baseline or new dialysis requirement postoperatively. Predictors of ARF were identified by multivariable logistic regression with corresponding adjusted odds ratio (AOR [95% CI]). Results Of 22,313 patients (age, 60.2 ± 13.7 years; 66.2% male) undergoing ATAAD repair at 868 hospitals, 3696 (16.6%) had ARF, and of these, 2918 (79.0%) required dialysis. ATAAD volume increased from 3693 in 2017 to 4334 in 2022 (P < .001), whereas the proportion of ARF decreased slightly yet significantly from 17.2% in 2017 to 16.3% in 2022 (P < .001). A well-calibrated and discriminating (C statistic, 0.77 [0.75-0.78]) multivariable model identified 27 independent predictors of ARF. Bilateral renal malperfusion (AOR, 4.88 [3.50-6.81]), preoperative creatinine per 0.1 mg/dL (AOR, 1.12 [1.11-1.14]), intraoperative transfusion (AOR, 1.63 [1.21-2.18]), and cardiogenic shock (AOR, 1.46 [1.24-1.72]) were strongly associated with increased ARF. Conversely, female sex (AOR, 0.72 [0.61-0.86]) was protective. Failure to rescue after ARF following ATAAD repair was 42% CONCLUSIONS: This study identified patient factors that significantly increase the risk of ARF after ATAAD repair that may alert the clinical team to implement potential protective interventions.
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References 24 · Cited by 6
Research works printed but not linked: 24
- Erbel, 2014, Eur Heart J, 35, 2873, 10.1093/eurheartj/ehu281 · DOI
- Masuda, 2016, Thoracic and cardiovascular surgery in Japan during 2014: annual report by The Japanese Association for Thoracic Surgery, Gen Thorac Cardiovasc Surg, 64, 665, 10.1007/s11748-016-0695-3 · DOI
- Trimarchi, 2005, Contemporary results of surgery in acute type A aortic dissection: the International Registry of Acute Aortic Dissection experience, J Thorac Cardiovasc Surg, 129, 112, 10.1016/j.jtcvs.2004.09.005 · DOI
- Chiappini, 2005, Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients, Eur Heart J, 26, 180, 10.1093/eurheartj/ehi024 · DOI
- Caceres Polo, 2020, Risk analysis and outcomes of postoperative renal failure after aortic valve surgery in the United States, Ann Thorac Surg, 109, 1133, 10.1016/j.athoracsur.2019.07.052 · DOI
- Helgason, 2021, Acute kidney injury after acute repair of type A aortic dissection, Ann Thorac Surg, 111, 1292, 10.1016/j.athoracsur.2020.07.019 · DOI
- Zhao, 2015, Risk factors for acute kidney injury in overweight patients with acute type A aortic dissection: a retrospective study, J Thorac Dis, 7, 1385
- Ko, 2015, Impact of acute kidney injury on early to long-term outcomes in patients who underwent surgery for type A acute aortic dissection, Am J Cardiol, 116, 463, 10.1016/j.amjcard.2015.04.043 · DOI
- VARC-3 Writing Committee, 2021, Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research, Eur Heart J, 42, 1825, 10.1093/eurheartj/ehaa799 · DOI
- Samanidis, 2022, Acute renal failure after acute type A aortic dissection repair. Insidious postoperative complication with poor short- and long-term prognosis, J Card Surg, 37, 2618, 10.1111/jocs.16613 · DOI
- Shahian, 2018, The Society of Thoracic Surgeons 2018 Adult Cardiac Surgery risk models: part 1—background, design considerations, and model development, Ann Thorac Surg, 105, 1411, 10.1016/j.athoracsur.2018.03.002 · DOI · Paper page
- Brown, 2022, The long-term impact of acute renal failure after aortic arch replacement for acute type A aortic dissection, J Card Surg, 37, 2378, 10.1111/jocs.16614 · DOI
- Gasser, 2022, Type A aortic dissection is more aggressive in women, Eur J Cardiothorac Surg, 62, 10.1093/ejcts/ezac040 · DOI
- Mousavizadeh, 2021, Hypothermic circulatory arrest time affects neurological outcomes of frozen elephant trunk for acute type A aortic dissection: a systematic review and meta-analysis, J Card Surg, 36, 3337, 10.1111/jocs.15700 · DOI
- Fichadiya, 2022, Neuroanatomy and severity of stroke in patients with type A aortic dissection, J Card Surg, 37, 339, 10.1111/jocs.16136 · DOI · Paper page
- Zindovic, 2019, Malperfusion in acute type A aortic dissection: an update from the Nordic Consortium for Acute Type A Aortic Dissection, J Thorac Cardiovasc Surg, 157, 1324, 10.1016/j.jtcvs.2018.10.134 · DOI
- De Corte, 2016, Long-term outcome in ICU patients with acute kidney injury treated with renal replacement therapy: a prospective cohort study, Crit Care, 20, 256, 10.1186/s13054-016-1409-z · DOI
- Wesselink, 1997, Cardiopulmonary-bypass time has important independent influence on mortality and morbidity, Eur J Cardiothorac Surg, 11, 1141, 10.1016/S1010-7940(97)01217-7 · DOI
- Wang, 2018, Independent risk factors for postoperative AKI and the impact of the AKI on 30-day postoperative outcomes in patients with type A acute aortic dissection: an updated meta-analysis and meta-regression, J Thorac Dis, 10, 2590, 10.21037/jtd.2018.05.47 · DOI
- Sasabuchi, 2016, Long-term survival in patients with acute kidney injury after acute type A aortic dissection repair, Ann Thorac Surg, 102, 2003, 10.1016/j.athoracsur.2016.05.006 · DOI
- Tsai, 2012, Impact of acute kidney injury on one-year survival after surgery for aortic dissection, Ann Thorac Surg, 94, 1407, 10.1016/j.athoracsur.2012.05.104 · DOI
- Roh, 2012, Incidence and risk factors of acute kidney injury after thoracic aortic surgery for acute dissection, Ann Thorac Surg, 94, 766, 10.1016/j.athoracsur.2012.04.057 · DOI
- Williams, 2015, Health policy, disparities, and the kidney, Adv Chronic Kidney Dis, 22, 54, 10.1053/j.ackd.2014.06.002 · DOI
- Kreibich, 2018, Outcome after operation for aortic dissection Type A in morbidly obese patients, Ann Thorac Surg, 106, 491, 10.1016/j.athoracsur.2018.03.035 · DOI
Metadata
- Authors
- Palaniappan, A., Bonnell, L. N., Blitzer, D., Takayama, H., Kaneko, T., Habib, R. H., & Sellke, F. W.
- Affiliations
- Brown University (US)
- Columbia University (US)
- Society of Thoracic Surgeons (US)
- Washington University in St. Louis (US)
- Corresponding author
- Sellke, Frank W.
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2025-06
- Volume
- 119
- Issue
- 6
- Pages
- 1231-1239
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W4405756840
- Cited by
- 6
- References
- 24
- Citations by year
- 2026: 3 · 2025: 3
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Annals of Thoracic Surgery (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion)
- Funders
- Society of Thoracic Surgeons
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Thrombus and Embolism
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- acute kidney injury, type A aortic dissection, aortic dissection repair, dialysis requirement, preoperative creatinine, intraoperative blood transfusion, cardiogenic shock, postoperative outcomes, risk factors, Society of Thoracic Surgeons Adult Cardiac Surgery Database, surgical volume trends, failure to rescue, length of hospital stay
- MeSH terms
- Aged, Aortic Dissection, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Risk Factors, Societies, Medical, Thoracic Surgery, Databases, Factual, Aortic Aneurysm, Thoracic, Acute Kidney Injury
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