التفاصيل البيبلوغرافية
| العنوان: |
Association of pediatric cardiac surgery-associated acute kidney injury with post-discharge healthcare utilization, mortality and kidney outcomes. |
| المؤلفون: |
Nunes, Sophia, Hessey, Erin, Dorais, Marc, Perreault, Sylvie, Jouvet, Philippe, Phan, Véronique, Lacroix, Jacques, Lafrance, Jean-Philippe, Samuel, Susan, Zappitelli, Michael |
| المصدر: |
Pediatric Nephrology; Sep2021, Vol. 36 Issue 9, p2865-2874, 10p, 1 Illustration, 1 Diagram, 3 Charts |
| مصطلحات موضوعية: |
HYPERTENSION risk factors, MORTALITY risk factors, CARDIAC surgery, CHRONIC kidney failure, CONFIDENCE intervals, PEDIATRICS, SURGICAL complications, RETROSPECTIVE studies, MEDICAL care use, POSTOPERATIVE period, DESCRIPTIVE statistics, DATA analysis software, ACUTE kidney failure, LONGITUDINAL method, PROPORTIONAL hazards models, DISEASE risk factors, CHILDREN |
| مستخلص: |
Background: Acute kidney Injury (AKI) in children undergoing cardiac surgery (CS) is strongly associated with hospital morbidity. Post-discharge CS AKI outcomes are less clear. We evaluated associations between AKI and post-discharge (a) healthcare utilization, (b) chronic kidney disease (CKD) or hypertension and (c) mortality. Methods: This is a retrospective two-centre cohort study of children surviving to hospital discharge after CS. Primary exposures were post-operative ≥Stage 1 AKI and ≥Stage 2 AKI defined by Kidney Disease Impoving Global Outcomes. Association of AKI with time to outcomes was determined using multivariable Cox-Proportional Hazards analysis. Results: Of 350 participants included (age 3.1 (4.5) years), 180 [51.4%] developed AKI and 60 [17.1%] developed ≥Stage 2 AKI. Twenty-eight (9%) participants developed CKD or hypertension (composite outcome), and 17 (5%) died within 5 years of discharge. Post-operative ≥Stage 1 and ≥Stage 2 AKI were not associated with post-discharge hospitalizations, emergency room (ER) visits, physician visits or CKD or hypertension in adjusted analyses. A trend was observed between ≥Stage 2 AKI and mortality but was not statistically significant. In unadjusted stratified analyses, AKI was associated with post-discharge hospitalizations in children with RACHS-1 score ≥3, complex chronic disease classification and children living in urban areas. Conclusions: Post-CS AKI is not associated with post-discharge healthcare utilization, death and CKD or hypertension, though it may be associated with healthcare utilization in more complex paediatric CS children. Studies should aim to better understand post-CS healthcare utilization patterns and non-AKI risk factors for CKD, hypertension and mortality, to reduce adverse long-term outcomes after CS. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
