Universität zu Köln

Eghbalzadeh, Kaveh, Sabashnikov, Anton, Weber, Carolyn, Zeriouh, Mohamed, Djordjevic, Ilija, Merkle, Julia, Shostak, Olga, Saenko, Sergey, Majd, Payman, Liakopoulos, Oliver, Rahmanian, Parwis B. ORCID: 0000-0002-3978-9251, Madershahian, Navid, Choi, Yeong-Noon, Kuhn-Regnier, Ferdinand, Wippermann, Jens and Wahlers, Thorsten (2018). Impact of preoperative elevated serum creatinine on long-term outcome of patients undergoing aortic repair with Stanford A dissection: a retrospective matched pair analysis. Ther. Adv. Cardiovasc. Dis., 12 (11). S. 289 - 299. LONDON: SAGE PUBLICATIONS LTD. ISSN 1753-9455

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Abstract

Background: The aim of the present study was to determine whether raised preoperative serum creatinine affected the long-term outcome in patients undergoing surgical aortic repair for Stanford A acute aortic dissection (AAD). Methods: A total of 240 patients diagnosed with Stanford A AAD underwent surgical repair from January 2006 to April 2015. A propensity score matching was applied, resulting in 73 pairs consisting of one group with normal and one group with preoperative elevated creatinine levels. The cohorts were well balanced for baseline and preoperative clinical characteristics. Both groups were compared regarding their early postoperative variables, as well as estimated survival with up to 9-year follow up. Also, the impact of acute postoperative kidney injury and its severity on long-term survival was analyzed. Results: The proportion of patients suffering Stanford A AAD with raised creatinine levels was 31.3% (n = 75). After propensity matching, there were no statistically significant differences regarding demographics, comorbidities, preoperative baseline and clinical characteristics. Postoperatively matched patients with elevated creatinine had longer intensive care unit (p < 0.001) and total hospital stay (p = 0.002), prolonged intubation times (p = 0.014), higher need for hemofiltration (p < 0.001), higher incidence of temporary neurological disorders (p = 0.16), infection (p = 0.005), and trend toward higher incidence of sepsis (p = 0.097). However, there were no significant differences regarding 30-day mortality (20.5% versus 20.5%, p = 1.000) and long-term overall survival. Further, neither the incidence nor the different stages of acute kidney injury according to the Acute Kidney Injury Network showed any statistically significant differences in terms of long-term survival for both groups [log rank p = 0.636, Breslow (generalized Wilcoxon) p = 0.470, Tarone-Ware p = 0.558]. Conclusions: Patients with elevated creatinine levels undergoing surgical repair for Stanford A AAD demonstrate higher rate of early postoperative complications. However, 30-day mortality and long-term survival in this patient cohort is not significantly impaired.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Djordjevic, Ilija UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Shostak, Olga UNSPECIFIED UNSPECIFIED UNSPECIFIED Saenko, Sergey UNSPECIFIED UNSPECIFIED UNSPECIFIED Majd, Payman UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis B. UNSPECIFIED orcid.org/0000-0002-3978-9251 UNSPECIFIED Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Noon UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-166112
DOI:	10.1177/1753944718798345
Journal or Publication Title:	Ther. Adv. Cardiovasc. Dis.
Volume:	12
Number:	11
Page Range:	S. 289 - 299
Date:	2018
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	1753-9455
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE KIDNEY INJURY; ACUTE-RENAL-FAILURE; REQUIRING DIALYSIS; CARDIAC-SURGERY; SURVIVAL Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16611