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Abstract：
The effects of surgical day (workdays or weekends) on occurrence and outcome of cardiac surgery associated -acute kidney injury (CSA-AKI) remains unclear. This study aimed to compare the incidence and short-term outcomes of CSA-AKI in patients undergoing surgery on workdays and weekends.
Patients who underwent cardiac surgery from July 2020 to December 2020 were retrospectively enrolled in this study. These patients were divided into a weekend group and workday group. The primary endpoint was the incidence of CSA-AKI. The secondary endpoints included renal function recovery and in-hospital mortality. The logistic regression model was used to explore the risk factors for CSA-AKI. Stratification analysis was performed to estimate the association between CSA-AKI and weekend surgery stratified by emergency surgery.
A total of 1974 patients undergoing cardiac surgery were enrolled. The incidence of CSA-AKI in the weekend group was significantly higher than that in the workday group (42.8% vs. 34.7%, P = 0.038). Further analysis of patients with CSA-AKI showed that there was no difference in renal function recovery between the workday AKI group and weekend AKI group. There was no difference in in-hospital mortality between the weekend group and workday group (3.6% vs. 2.4%, P = 0.327); however, the in-hospital mortality of the weekend AKI group was significantly higher than that of the workday AKI group (8.5% vs. 2.9%, P = 0.014). Weekend surgery and emergency surgery were independent risk factors for CSA-AKI. The multiplicative model showed an interaction between weekend surgery and emergency surgery; weekend surgery was related to an increased risk of AKI among patients undergoing emergency surgery [adjusted OR (95% CI): 1.96 (1.012-8.128)].
The incidence of CSA-AKI in patients undergoing cardiac surgery on weekends was significantly higher compared to that in patients undergoing cardiac surgery on workdays. Weekend surgery did not affect the in-hospital mortality of all patients but significantly increased the mortality of AKI patients. Weekend surgery and emergency surgery were independent risk factors for CSA-AKI. Weekend emergency surgery significantly increased the risk of CSA-AKI.
Patients who underwent cardiac surgery from July 2020 to December 2020 were retrospectively enrolled in this study. These patients were divided into a weekend group and workday group. The primary endpoint was the incidence of CSA-AKI. The secondary endpoints included renal function recovery and in-hospital mortality. The logistic regression model was used to explore the risk factors for CSA-AKI. Stratification analysis was performed to estimate the association between CSA-AKI and weekend surgery stratified by emergency surgery.
A total of 1974 patients undergoing cardiac surgery were enrolled. The incidence of CSA-AKI in the weekend group was significantly higher than that in the workday group (42.8% vs. 34.7%, P = 0.038). Further analysis of patients with CSA-AKI showed that there was no difference in renal function recovery between the workday AKI group and weekend AKI group. There was no difference in in-hospital mortality between the weekend group and workday group (3.6% vs. 2.4%, P = 0.327); however, the in-hospital mortality of the weekend AKI group was significantly higher than that of the workday AKI group (8.5% vs. 2.9%, P = 0.014). Weekend surgery and emergency surgery were independent risk factors for CSA-AKI. The multiplicative model showed an interaction between weekend surgery and emergency surgery; weekend surgery was related to an increased risk of AKI among patients undergoing emergency surgery [adjusted OR (95% CI): 1.96 (1.012-8.128)].
The incidence of CSA-AKI in patients undergoing cardiac surgery on weekends was significantly higher compared to that in patients undergoing cardiac surgery on workdays. Weekend surgery did not affect the in-hospital mortality of all patients but significantly increased the mortality of AKI patients. Weekend surgery and emergency surgery were independent risk factors for CSA-AKI. Weekend emergency surgery significantly increased the risk of CSA-AKI.
摘要：
背景：手术日（工作日或周末）对心脏手术相关急性肾损伤（CSA-AKI）发生和结果的影响尚不清楚。这项研究旨在比较CSA-AKI在工作日和周末接受手术的患者的发生率和短期结果。
方法：回顾性纳入2020年7月至2020年12月接受心脏手术的患者。将这些患者分为周末组和工作日组。主要终点是CSA-AKI的发生率。次要终点包括肾功能恢复和院内死亡率。采用logistic回归模型探讨CSA-AKI的危险因素。进行分层分析以估计CSA-AKI与急诊手术分层的周末手术之间的关联。
结果：共纳入1974例心脏手术患者。周末组CSA-AKI发生率明显高于工作日组(42.8%vs.34.7%,P=0.038)。对CSA-AKI患者的进一步分析显示，工作日AKI组与周末AKI组的肾功能恢复无差异。周末组和工作日组的住院死亡率没有差异(3.6%vs.2.4%,P=0.327)；然而，周末AKI组的住院死亡率明显高于工作日AKI组(8.5%vs.2.9%,P=0.014)。周末手术和急诊手术是CSA-AKI的独立危险因素。乘法模型显示周末手术和急诊手术之间的相互作用；周末手术与急诊手术患者的AKI风险增加相关[调整后OR（95％CI）：1.96（1.012-8.128）]。
结论：周末心脏手术患者的CSA-AKI发生率明显高于工作日心脏手术患者。周末手术不影响所有患者的院内死亡率，但显著增加了AKI患者的死亡率。周末手术和急诊手术是CSA-AKI的独立危险因素。周末急诊手术显著增加CSA-AKI的风险。
方法：回顾性纳入2020年7月至2020年12月接受心脏手术的患者。将这些患者分为周末组和工作日组。主要终点是CSA-AKI的发生率。次要终点包括肾功能恢复和院内死亡率。采用logistic回归模型探讨CSA-AKI的危险因素。进行分层分析以估计CSA-AKI与急诊手术分层的周末手术之间的关联。
结果：共纳入1974例心脏手术患者。周末组CSA-AKI发生率明显高于工作日组(42.8%vs.34.7%,P=0.038)。对CSA-AKI患者的进一步分析显示，工作日AKI组与周末AKI组的肾功能恢复无差异。周末组和工作日组的住院死亡率没有差异(3.6%vs.2.4%,P=0.327)；然而，周末AKI组的住院死亡率明显高于工作日AKI组(8.5%vs.2.9%,P=0.014)。周末手术和急诊手术是CSA-AKI的独立危险因素。乘法模型显示周末手术和急诊手术之间的相互作用；周末手术与急诊手术患者的AKI风险增加相关[调整后OR（95％CI）：1.96（1.012-8.128）]。
结论：周末心脏手术患者的CSA-AKI发生率明显高于工作日心脏手术患者。周末手术不影响所有患者的院内死亡率，但显著增加了AKI患者的死亡率。周末手术和急诊手术是CSA-AKI的独立危险因素。周末急诊手术显著增加CSA-AKI的风险。
