Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler
Objectives. This study is aimed to evaluate the efficiency in early prediction of postoperative persistent acute kidney injury (PAKI) after surgery in acute Stanford type A aortic dissection (AAAD) patients by using Doppler renal resistive index (RRI) and semiquantitative color (SQC) Doppler grade,...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/4381052 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832546114754052096 |
|---|---|
| author | Huai Qin Yaqiong Li Nan Zhang Tiezhu Wang Zhanming Fan |
| author_facet | Huai Qin Yaqiong Li Nan Zhang Tiezhu Wang Zhanming Fan |
| author_sort | Huai Qin |
| collection | DOAJ |
| description | Objectives. This study is aimed to evaluate the efficiency in early prediction of postoperative persistent acute kidney injury (PAKI) after surgery in acute Stanford type A aortic dissection (AAAD) patients by using Doppler renal resistive index (RRI) and semiquantitative color (SQC) Doppler grade, respectively. Methods. 84 AAAD patients received Sun’s surgical management, and 67 patients were enrolled. RRI and SQC Doppler grade were evaluated by ultrasonography, respectively, at 6 hours after surgery. Serum creatinine (sCr) was recorded before operation and at 24 hours, 48 hours, and 72 hours after operation. AKI grade was evaluated according to the classifications of the Acute Kidney Injury Network (AKIN). PAKI is defined as persistent oliguria and/or sCr elevation after 3 days. RRI and SQC Doppler grade were compared, respectively, between the PAKI and non-PAKI groups. Potential predictors were first tested by univariate logistic regression analysis, and a multivariate model was identified to determine the independent predictive ability of RRI and SQC Doppler grade for the PAKI. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic accuracy between RRI and SQC Doppler grade in early prediction of PAKI by using AKIN classifications as the reference standard. Results. Of a total of 67 patients enrolled during the study period, 21 (31.3%) patients suffered from PAKI and 8 (11.9%) patients required dialysis. There are significant differences in RRI (0.80 ± 0.09 vs. 0.70 ± 0.05, P=0.002) and SQC Doppler grade (x2=12.193, P=0.007) between the 2 groups with and without PAKI. Univariate analysis showed that RRI, SQC Doppler grade, length of stay in ICU, time of CPB, and length of stay in hospital were significant predictors of PAKI. RRI and the SQC Doppler grade remained independent predictors of PAKI. Area under the curve (AUC) of RRI was 0.855 (95% CI, 0.74–0.96) with cutoff value 0.725 (sensitivity 90.9% and specificity 71.1%), AUC of SQC Doppler grade was 0.642 (95% CI, 0.49–0.79) with cutoff value grade 2 (sensitivity 50% and specificity 73.3%). Conclusion. Both postoperative RRI and SQC Doppler grade are independent predictors for PAKI after surgery in AAAD patients. Both postoperative RRI and SQC Doppler grade can be obtained rapidly by bedside ultrasound, which is a good tool for early prediction for postoperative PAKI. |
| format | Article |
| id | doaj-art-1d3215f00b954e76915bd863b329d604 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-1d3215f00b954e76915bd863b329d6042025-02-03T07:23:50ZengWileyCardiology Research and Practice2090-80162090-05972019-01-01201910.1155/2019/43810524381052Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color DopplerHuai Qin0Yaqiong Li1Nan Zhang2Tiezhu Wang3Zhanming Fan4Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, ChinaDepartment of Cardiovascular Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Aortic Disease Center, Beijing, ChinaDepartment of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, ChinaDepartment of Ultrasound, Hospital of Renmin University of China, Beijing, ChinaDepartment of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, ChinaObjectives. This study is aimed to evaluate the efficiency in early prediction of postoperative persistent acute kidney injury (PAKI) after surgery in acute Stanford type A aortic dissection (AAAD) patients by using Doppler renal resistive index (RRI) and semiquantitative color (SQC) Doppler grade, respectively. Methods. 84 AAAD patients received Sun’s surgical management, and 67 patients were enrolled. RRI and SQC Doppler grade were evaluated by ultrasonography, respectively, at 6 hours after surgery. Serum creatinine (sCr) was recorded before operation and at 24 hours, 48 hours, and 72 hours after operation. AKI grade was evaluated according to the classifications of the Acute Kidney Injury Network (AKIN). PAKI is defined as persistent oliguria and/or sCr elevation after 3 days. RRI and SQC Doppler grade were compared, respectively, between the PAKI and non-PAKI groups. Potential predictors were first tested by univariate logistic regression analysis, and a multivariate model was identified to determine the independent predictive ability of RRI and SQC Doppler grade for the PAKI. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic accuracy between RRI and SQC Doppler grade in early prediction of PAKI by using AKIN classifications as the reference standard. Results. Of a total of 67 patients enrolled during the study period, 21 (31.3%) patients suffered from PAKI and 8 (11.9%) patients required dialysis. There are significant differences in RRI (0.80 ± 0.09 vs. 0.70 ± 0.05, P=0.002) and SQC Doppler grade (x2=12.193, P=0.007) between the 2 groups with and without PAKI. Univariate analysis showed that RRI, SQC Doppler grade, length of stay in ICU, time of CPB, and length of stay in hospital were significant predictors of PAKI. RRI and the SQC Doppler grade remained independent predictors of PAKI. Area under the curve (AUC) of RRI was 0.855 (95% CI, 0.74–0.96) with cutoff value 0.725 (sensitivity 90.9% and specificity 71.1%), AUC of SQC Doppler grade was 0.642 (95% CI, 0.49–0.79) with cutoff value grade 2 (sensitivity 50% and specificity 73.3%). Conclusion. Both postoperative RRI and SQC Doppler grade are independent predictors for PAKI after surgery in AAAD patients. Both postoperative RRI and SQC Doppler grade can be obtained rapidly by bedside ultrasound, which is a good tool for early prediction for postoperative PAKI.http://dx.doi.org/10.1155/2019/4381052 |
| spellingShingle | Huai Qin Yaqiong Li Nan Zhang Tiezhu Wang Zhanming Fan Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler Cardiology Research and Practice |
| title | Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler |
| title_full | Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler |
| title_fullStr | Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler |
| title_full_unstemmed | Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler |
| title_short | Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler |
| title_sort | prediction efficiency of postoperative acute kidney injury in acute stanford type a aortic dissection patients with renal resistive index and semiquantitative color doppler |
| url | http://dx.doi.org/10.1155/2019/4381052 |
| work_keys_str_mv | AT huaiqin predictionefficiencyofpostoperativeacutekidneyinjuryinacutestanfordtypeaaorticdissectionpatientswithrenalresistiveindexandsemiquantitativecolordoppler AT yaqiongli predictionefficiencyofpostoperativeacutekidneyinjuryinacutestanfordtypeaaorticdissectionpatientswithrenalresistiveindexandsemiquantitativecolordoppler AT nanzhang predictionefficiencyofpostoperativeacutekidneyinjuryinacutestanfordtypeaaorticdissectionpatientswithrenalresistiveindexandsemiquantitativecolordoppler AT tiezhuwang predictionefficiencyofpostoperativeacutekidneyinjuryinacutestanfordtypeaaorticdissectionpatientswithrenalresistiveindexandsemiquantitativecolordoppler AT zhanmingfan predictionefficiencyofpostoperativeacutekidneyinjuryinacutestanfordtypeaaorticdissectionpatientswithrenalresistiveindexandsemiquantitativecolordoppler |