Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery

H. J. Safi, S. A. Harlin, C. C. Miller, D. C. Iliopoulos, A. Joshi, M. Tabor, R. Zippel, G. V. Letsou, G. M. Williams, [No Value] Cambria

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this study was to analyze the factors associated with acute renal failure in total descending thoracic and thoracoabdominal aortic aneurysm surgery. Methods: A total of 234 patients underwent thoracoabdominal aortic aneurysm or total descending thoracic aneurysm repair between January 1991 and January 1994. Eighty-five women and 149 men were evaluated. The median age was 67 years (range 8 to 88 years). Seventy-seven patients had type I thoracoabdominal aortic aneurysm, 99 had type II, 51 had type III or IV, and 7 had total descending thoracic aneurysm. Factors such as age, sex, aneurysm type, and visceral and distal aortic perfusion were examined with univariate fourfold table and multivariate logistic regression analysis. Results: Acute renal failure, defined as an increase in serum creatinine by 1 mg/dl per day for two consecutive days after surgery, occurred in 41 (17.5%) of 234 patients. Thirty-six (15%) of 234 patients required dialysis. Twenty (49%) of 41 patients with acute renal failure died. Of the 21 survivors with renal failure, renal failure resolved in 18 (86%) within 30 days of surgery. The univariate odds ratio of death, given acute renal failure, was 6.7 (95% confidence interval [CI] 3.2 to 14.2, p <00001). No significant association was found between the probability of acute renal failure and age, sex, hypertension, right renal artery reattachment, or renal bypass. Factors associated with increased risk of acute renal failure in multivariate analysis were visceral perfusion (odds ratio [OR] = 3.6 95%, CI 1.2 to 11.0, p <0.02), left renal artery reattachment (OR = 4.4 95%, CI 1.6 to 11.9, p <0.004), preoperative creatinine ≤2.8 mg/dl (OR = 10.3, 95% CI 12.0 to 411.8, p <0.0001), and simple clamp technique (OR = 3.4 95%, CI 1.07 to 10.76, p <0.04). Direct univariate correlation was seen between preoperative creatinine and acute renal failure (OR = 3.2 per mg/dl increase, 95% CI 2.7 to 10.1, p <0.0001). Conclusion: Postoperative acute renal failure after thoracoabdominal and total descending thoracic aortic aneurysm surgery is associated with preoperative creatinine level, visceral perfusion, left renal artery reattachment, and simple cross-clamp technique.

Original languageEnglish (US)
Pages (from-to)338-345
Number of pages8
JournalJournal of Vascular Surgery
Volume24
Issue number3
DOIs
StatePublished - 1996
Externally publishedYes

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Thoracic Aortic Aneurysm
Acute Kidney Injury
Odds Ratio
Confidence Intervals
Creatinine
Renal Artery
Aneurysm
Perfusion
Ambulatory Surgical Procedures
Renal Insufficiency
Thorax
Statistical Factor Analysis
Survivors
Dialysis
Multivariate Analysis
Logistic Models
Regression Analysis
Hypertension
Kidney

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Safi, H. J., Harlin, S. A., Miller, C. C., Iliopoulos, D. C., Joshi, A., Tabor, M., ... Cambria, N. V. (1996). Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery. Journal of Vascular Surgery, 24(3), 338-345. https://doi.org/10.1016/S0741-5214(96)70189-1

Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery. / Safi, H. J.; Harlin, S. A.; Miller, C. C.; Iliopoulos, D. C.; Joshi, A.; Tabor, M.; Zippel, R.; Letsou, G. V.; Williams, G. M.; Cambria, [No Value].

In: Journal of Vascular Surgery, Vol. 24, No. 3, 1996, p. 338-345.

Research output: Contribution to journalArticle

Safi, HJ, Harlin, SA, Miller, CC, Iliopoulos, DC, Joshi, A, Tabor, M, Zippel, R, Letsou, GV, Williams, GM & Cambria, NV 1996, 'Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery', Journal of Vascular Surgery, vol. 24, no. 3, pp. 338-345. https://doi.org/10.1016/S0741-5214(96)70189-1
Safi, H. J. ; Harlin, S. A. ; Miller, C. C. ; Iliopoulos, D. C. ; Joshi, A. ; Tabor, M. ; Zippel, R. ; Letsou, G. V. ; Williams, G. M. ; Cambria, [No Value]. / Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery. In: Journal of Vascular Surgery. 1996 ; Vol. 24, No. 3. pp. 338-345.
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abstract = "Purpose: The purpose of this study was to analyze the factors associated with acute renal failure in total descending thoracic and thoracoabdominal aortic aneurysm surgery. Methods: A total of 234 patients underwent thoracoabdominal aortic aneurysm or total descending thoracic aneurysm repair between January 1991 and January 1994. Eighty-five women and 149 men were evaluated. The median age was 67 years (range 8 to 88 years). Seventy-seven patients had type I thoracoabdominal aortic aneurysm, 99 had type II, 51 had type III or IV, and 7 had total descending thoracic aneurysm. Factors such as age, sex, aneurysm type, and visceral and distal aortic perfusion were examined with univariate fourfold table and multivariate logistic regression analysis. Results: Acute renal failure, defined as an increase in serum creatinine by 1 mg/dl per day for two consecutive days after surgery, occurred in 41 (17.5{\%}) of 234 patients. Thirty-six (15{\%}) of 234 patients required dialysis. Twenty (49{\%}) of 41 patients with acute renal failure died. Of the 21 survivors with renal failure, renal failure resolved in 18 (86{\%}) within 30 days of surgery. The univariate odds ratio of death, given acute renal failure, was 6.7 (95{\%} confidence interval [CI] 3.2 to 14.2, p <00001). No significant association was found between the probability of acute renal failure and age, sex, hypertension, right renal artery reattachment, or renal bypass. Factors associated with increased risk of acute renal failure in multivariate analysis were visceral perfusion (odds ratio [OR] = 3.6 95{\%}, CI 1.2 to 11.0, p <0.02), left renal artery reattachment (OR = 4.4 95{\%}, CI 1.6 to 11.9, p <0.004), preoperative creatinine ≤2.8 mg/dl (OR = 10.3, 95{\%} CI 12.0 to 411.8, p <0.0001), and simple clamp technique (OR = 3.4 95{\%}, CI 1.07 to 10.76, p <0.04). Direct univariate correlation was seen between preoperative creatinine and acute renal failure (OR = 3.2 per mg/dl increase, 95{\%} CI 2.7 to 10.1, p <0.0001). Conclusion: Postoperative acute renal failure after thoracoabdominal and total descending thoracic aortic aneurysm surgery is associated with preoperative creatinine level, visceral perfusion, left renal artery reattachment, and simple cross-clamp technique.",
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T1 - Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery

AU - Safi, H. J.

AU - Harlin, S. A.

AU - Miller, C. C.

AU - Iliopoulos, D. C.

AU - Joshi, A.

AU - Tabor, M.

AU - Zippel, R.

AU - Letsou, G. V.

AU - Williams, G. M.

AU - Cambria, [No Value]

PY - 1996

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N2 - Purpose: The purpose of this study was to analyze the factors associated with acute renal failure in total descending thoracic and thoracoabdominal aortic aneurysm surgery. Methods: A total of 234 patients underwent thoracoabdominal aortic aneurysm or total descending thoracic aneurysm repair between January 1991 and January 1994. Eighty-five women and 149 men were evaluated. The median age was 67 years (range 8 to 88 years). Seventy-seven patients had type I thoracoabdominal aortic aneurysm, 99 had type II, 51 had type III or IV, and 7 had total descending thoracic aneurysm. Factors such as age, sex, aneurysm type, and visceral and distal aortic perfusion were examined with univariate fourfold table and multivariate logistic regression analysis. Results: Acute renal failure, defined as an increase in serum creatinine by 1 mg/dl per day for two consecutive days after surgery, occurred in 41 (17.5%) of 234 patients. Thirty-six (15%) of 234 patients required dialysis. Twenty (49%) of 41 patients with acute renal failure died. Of the 21 survivors with renal failure, renal failure resolved in 18 (86%) within 30 days of surgery. The univariate odds ratio of death, given acute renal failure, was 6.7 (95% confidence interval [CI] 3.2 to 14.2, p <00001). No significant association was found between the probability of acute renal failure and age, sex, hypertension, right renal artery reattachment, or renal bypass. Factors associated with increased risk of acute renal failure in multivariate analysis were visceral perfusion (odds ratio [OR] = 3.6 95%, CI 1.2 to 11.0, p <0.02), left renal artery reattachment (OR = 4.4 95%, CI 1.6 to 11.9, p <0.004), preoperative creatinine ≤2.8 mg/dl (OR = 10.3, 95% CI 12.0 to 411.8, p <0.0001), and simple clamp technique (OR = 3.4 95%, CI 1.07 to 10.76, p <0.04). Direct univariate correlation was seen between preoperative creatinine and acute renal failure (OR = 3.2 per mg/dl increase, 95% CI 2.7 to 10.1, p <0.0001). Conclusion: Postoperative acute renal failure after thoracoabdominal and total descending thoracic aortic aneurysm surgery is associated with preoperative creatinine level, visceral perfusion, left renal artery reattachment, and simple cross-clamp technique.

AB - Purpose: The purpose of this study was to analyze the factors associated with acute renal failure in total descending thoracic and thoracoabdominal aortic aneurysm surgery. Methods: A total of 234 patients underwent thoracoabdominal aortic aneurysm or total descending thoracic aneurysm repair between January 1991 and January 1994. Eighty-five women and 149 men were evaluated. The median age was 67 years (range 8 to 88 years). Seventy-seven patients had type I thoracoabdominal aortic aneurysm, 99 had type II, 51 had type III or IV, and 7 had total descending thoracic aneurysm. Factors such as age, sex, aneurysm type, and visceral and distal aortic perfusion were examined with univariate fourfold table and multivariate logistic regression analysis. Results: Acute renal failure, defined as an increase in serum creatinine by 1 mg/dl per day for two consecutive days after surgery, occurred in 41 (17.5%) of 234 patients. Thirty-six (15%) of 234 patients required dialysis. Twenty (49%) of 41 patients with acute renal failure died. Of the 21 survivors with renal failure, renal failure resolved in 18 (86%) within 30 days of surgery. The univariate odds ratio of death, given acute renal failure, was 6.7 (95% confidence interval [CI] 3.2 to 14.2, p <00001). No significant association was found between the probability of acute renal failure and age, sex, hypertension, right renal artery reattachment, or renal bypass. Factors associated with increased risk of acute renal failure in multivariate analysis were visceral perfusion (odds ratio [OR] = 3.6 95%, CI 1.2 to 11.0, p <0.02), left renal artery reattachment (OR = 4.4 95%, CI 1.6 to 11.9, p <0.004), preoperative creatinine ≤2.8 mg/dl (OR = 10.3, 95% CI 12.0 to 411.8, p <0.0001), and simple clamp technique (OR = 3.4 95%, CI 1.07 to 10.76, p <0.04). Direct univariate correlation was seen between preoperative creatinine and acute renal failure (OR = 3.2 per mg/dl increase, 95% CI 2.7 to 10.1, p <0.0001). Conclusion: Postoperative acute renal failure after thoracoabdominal and total descending thoracic aortic aneurysm surgery is associated with preoperative creatinine level, visceral perfusion, left renal artery reattachment, and simple cross-clamp technique.

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