Analysis of risk factors for continuous renal replacement therapy in patients with acute renal injury after type A aortic dissection surgery
Objective:To analyze the risk factors of death and the relationship between the timing of continuous renal replacement therapy(CRRT)and prognosis in patients with acute renal injury(AKI)after Stanford type A aortic dissection surgery(AD).Methods:Totally,39 patients with Stanford type A AD complicated with AKI were selected retrospectively,including 18 patients in survival group and 21 patients in death group.The perioperative parameters and risk factors of death were analyzed.The effect of early(within 48 h after operation)and late(after 48 h after operation)CRRT on survival rate was analyzed.Results:There were no significant differences in age,sex,body mass index(BMI),relevant medical history,blood routine,serum creatinine,cardiac ultrasound,data of cardiopulmonary bypass,blood loss during operation,transfu-sion of red blood cell suspension,hemostasis after twice thoracotomy and use of vasoactive drugs between the two groups(P＞0.05).Age(HR=1.115,P=0.01,95％CI:1.046-1.189)and serum creatinine(HR=1.013,P=0.035,95％CI:1.006-1.067)were independent risk factors for the outcome of patients with Stanford type A postoperative AKI undergo-ing CRRT.The 3-month mortality rate in early CRRT group was lower than that in late CRRT group,but the difference was not significant(P=0.624).Conclusion:Age and creatinine are independent risk factors for the prognosis of patients under-going CRRT with postoperative AKI of Stanford type A.Whether or not to do CRRT early had no effect on the prognosis of patients within 3 months.
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