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Abstract：
BACKGROUND: Off-pump coronary artery bypass grafting (OPCABG) presents distinct hemodynamic characteristics, yet the relationship between intraoperative hypotension and short-term adverse outcomes remains clear. Our study aims to investigate association between intraoperative hypotension and postoperative acute kidney injury (AKI), mortality and length of stay in OPCABG patients.
METHODS: Retrospective data of 494 patients underwent OPCABG from January 2016 to July 2023 were collected. We analyzed the relationship between intraoperative various hypotension absolute values (MAP > 75, 65 < MAP ≤ 75, 55 < MAP ≤ 65, MAP ≤ 55 mmHg) and postoperative AKI, mortality and length of stay. Logistic regression assessed the impacts of exposure variable on AKI and postoperative mortality. Linear regression was used to analyze risk factors on the length of intensive care unit stay (ICU) and hospital stay.
RESULTS: The incidence of AKI was 31.8%, with in-hospital and 30-day mortality at 2.8% and 3.5%, respectively. Maintaining a MAP greater than or equal 65 mmHg [odds ratio (OR) 0.408; p = 0.008] and 75 mmHg (OR 0.479; p = 0.024) was significantly associated with a decrease risk of AKI compared to MAP less than 55 mmHg for at least 10 min. Prolonged hospital stays were linked to low MAP, while in-hospital mortality and 30-day mortality were not linked to IOH but exhibited correlation with a history of myocardial infarction. AKI showed correlation with length of ICU stay.
CONCLUSIONS: MAP > 65 mmHg emerges as a significant independent protective factor for AKI in OPCABG and IOH is related to length of hospital stay. Proactive intervention targeting intraoperative hypotension may provide a potential opportunity to reduce postoperative renal injury and hospital stay.
BACKGROUND: ChiCTR2400082518. Registered 31 March 2024. https://www.chictr.org.cn/bin/project/edit?pid=225349 .
METHODS: Retrospective data of 494 patients underwent OPCABG from January 2016 to July 2023 were collected. We analyzed the relationship between intraoperative various hypotension absolute values (MAP > 75, 65 < MAP ≤ 75, 55 < MAP ≤ 65, MAP ≤ 55 mmHg) and postoperative AKI, mortality and length of stay. Logistic regression assessed the impacts of exposure variable on AKI and postoperative mortality. Linear regression was used to analyze risk factors on the length of intensive care unit stay (ICU) and hospital stay.
RESULTS: The incidence of AKI was 31.8%, with in-hospital and 30-day mortality at 2.8% and 3.5%, respectively. Maintaining a MAP greater than or equal 65 mmHg [odds ratio (OR) 0.408; p = 0.008] and 75 mmHg (OR 0.479; p = 0.024) was significantly associated with a decrease risk of AKI compared to MAP less than 55 mmHg for at least 10 min. Prolonged hospital stays were linked to low MAP, while in-hospital mortality and 30-day mortality were not linked to IOH but exhibited correlation with a history of myocardial infarction. AKI showed correlation with length of ICU stay.
CONCLUSIONS: MAP > 65 mmHg emerges as a significant independent protective factor for AKI in OPCABG and IOH is related to length of hospital stay. Proactive intervention targeting intraoperative hypotension may provide a potential opportunity to reduce postoperative renal injury and hospital stay.
BACKGROUND: ChiCTR2400082518. Registered 31 March 2024. https://www.chictr.org.cn/bin/project/edit?pid=225349 .
摘要：
背景：非体外循环冠状动脉旁路移植术（OPCABG）具有明显的血流动力学特征，然而,术中低血压与短期不良结局之间的关系仍然清晰.本研究旨在探讨术中低血压与术后急性肾损伤(AKI)的关系。OPCABG患者的死亡率和住院时间。
方法：收集2016年1月至2023年7月接受OPCABG的494例患者的回顾性资料。我们分析了术中各种低血压绝对值（MAP>75，65结果：AKI的发生率为31.8％，住院和30天死亡率分别为2.8%和3.5%，分别。保持MAP大于或等于65mmHg[比值比（OR）0.408;p=0.008]和75mmHg（OR0.479;p=0.024）与MAP小于55mmHg至少10分钟相比，AKI风险降低显着相关。住院时间延长与低MAP有关,而院内死亡率和30日死亡率与IOH无关,但与心肌梗死病史相关.AKI与ICU住院时间相关。
结论：MAP>65mmHg是OPCABG患者AKI的重要独立保护因素，IOH与住院时间有关。针对术中低血压的积极干预可能为减少术后肾损伤和住院时间提供潜在的机会。
背景：ChiCTR2400082518。2024年3月31日注册。https://www.chictr.org.cn/bin/project/edit?pid=225349。
方法：收集2016年1月至2023年7月接受OPCABG的494例患者的回顾性资料。我们分析了术中各种低血压绝对值（MAP>75，65
结论：MAP>65mmHg是OPCABG患者AKI的重要独立保护因素，IOH与住院时间有关。针对术中低血压的积极干预可能为减少术后肾损伤和住院时间提供潜在的机会。
背景：ChiCTR2400082518。2024年3月31日注册。https://www.chictr.org.cn/bin/project/edit?pid=225349。
