Impact of Acute Kidney Injury on Outcomes and Mortality after Bentall Surgery

Objectives: Acute kidney injury (AKI) after cardiac surgery is a well-known risk factor for increased postoperative mortality and morbidity. The aim of the present study was to assess impact of postoperative AKI development on outcomes and mortality of patients undergoing Bentall surgery in particular.

Methods: The study included 249 patients diagnosed for Bentall procedure who were referred to our institution for surgical treatment from January 2014 to March 2018. After excluding patients with preoperative renal impairment, the cohort was divided into an AKI group (n = 88) and non-AKI group (n = 97). Using univariate regression analysis, odds ratios of outcomes and 30-day mortality were analyzed.

Results: Coronary artery bypass time as well as cross-clamp time was similarly distributed between groups, whereas incidence of postoperative complications in terms of bleeding, myocardial infarction, and need for rethorax occurred significantly more often in patients with postoperatively developed AKI (all p < 0.04). Mortality during ICU and hospital stay and 30-day mortality rates were significantly higher in AKI group (all p < 0.001). Patients with development of postoperative AKI significantly revealed a 9.24-fold odds for ICU mortality and a 6.71-fold odds for 30-day mortality in comparison to non-AKI group (all p < 0.004) as well as 4.54-fold odds for stroke.

Conclusion: Patients undergoing Bentall surgery who postoperatively developed AKI showed significantly higher morbidity and mortality. Thus, as a consequence, patients with postoperatively developed AKI should be highly monitored for immediate intervention.

No conflict of interest has been declared by the author(s).