TITLE:
Patient Frailty Can Increase the Risk of Acute Kidney Injury after Cardiac Surgery: Pilot Study
AUTHORS:
Sergio Soto-Hopkins, José Antonio Sanchez-Lopez, Erick Trujillo-Magallón, Ron Leder, Ana Gabriela Gallardo-Hernandez
KEYWORDS:
Cardiac Surgery, Heart-Lung Machine, Acute Kidney Injury, Frailty, Cardiopulmonary Bypass
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.12 No.10,
October
17,
2022
ABSTRACT: Background: Acute kidney injury (AKI) is a severe common postoperative complication
of cardiac surgery (CS). It increases the risk of mortality by up to 80%.
Therefore, it is essential to have preoperative risk evaluation tools. Frailty
is a marker of deterioration of physiologic systems and may be associated with
AKI. Purpose: The study aimed to determine the utility of frailty as a
predictor of AKI after CS. Method: We enrolled 91 patients undergoing CS with cardiopulmonary bypass to
determine if they had frailty before surgery and were associated with
postoperative AKI. The diagnosis of postoperative AKI was based on the serum
creatinine criteria of the Acute Kidney Injury Network classification up to 7
days following CS. Results: The incidence of postoperative AKI was 62%
in the frail group and 21% in the non-frail group. Frailty was associated with
a higher risk of AKI (relative risk [RR] = 3.00,
95% CI 1.56 - 5.77, p = 0.00).
In regression models, there were associations between frailty and postoperative
AKI. Conclusion: This study demonstrated that frailty could be a
predictor for post-CS AKI. Therefore, frailty
assessment should become an essential part of the preoperative evaluation to
help the anesthesiologist to estimate the surgical risk and develop preoperative
and transoperative strategies to preserve the renal function and improve the
cardiac surgery outcome.