Risk factors for acute renal failure requiring dialysis after surgery for congenital heart disease in children
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Risk factors for acute renal failure requiring dialysis after surgery for congenital heart disease in children. / Pedersen, K. R.; Povlsen, J. V.; Christensen, S.; Pedersen, J.; Hjortholm, K.; Larsen, S. H.; Hjortdal, V. E.
I: Acta Anaesthesiologica Scandinavica, Bind 51, Nr. 10, 2007, s. 1344-1349.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Risk factors for acute renal failure requiring dialysis after surgery for congenital heart disease in children
AU - Pedersen, K. R.
AU - Povlsen, J. V.
AU - Christensen, S.
AU - Pedersen, J.
AU - Hjortholm, K.
AU - Larsen, S. H.
AU - Hjortdal, V. E.
PY - 2007
Y1 - 2007
N2 - BACKGROUND: Limited data exist on the risk factors for acute renal failure (ARF) following cardiac surgery in children with congenital heart disease. This cohort study was conducted to examine this subject, as well as changes in the incidence of ARF from 1993 to 2002, the in-hospital mortality and the time spent in the intensive care unit (ICU).METHODS: One thousand, one hundred and twenty-eight children, operated on for congenital heart disease between 1993 and 2002, were identified from our prospectively collected ICU database to obtain data on potential risk factors.RESULTS: A total of 130 children (11.5%) developed ARF after surgery. A young age [> or =1.0 vs. <0.1 year; odds ratio (OR), 0.23; 95% confidence interval (CI), 0.12-0.46], high Risk Adjusted Classification of Congenital Heart Surgery (RACHS-1) score (OR, 2.72; 95% CI, 1.66-4.45) and cardiopulmonary bypass (CPB) (<90 min vs. none; OR, 2.68; 95% CI, 1.03-6.96; > or =90 min vs. none; OR, 12.94; 95% CI, 5.46-30.67) were independent risk factors for ARF. The risk of ARF decreased during the study period. Children with ARF spent a significantly longer time in the ICU (2-7 days vs. <2 days, P = 0.002; > or =7 days vs. <2 days, P < 0.001) compared with non-ARF patients, and showed increased in-hospital mortality (20% vs. 5%, P < 0.001).CONCLUSION: A young age, high RACHS-1 score and CPB were independent risk factors for ARF after surgical procedures for congenital heart disease in children. The risk of ARF decreased during the study period. Children with severe ARF spent a longer time in the ICU, and the mortality in ARF patients was higher than that in non-ARF patients.
AB - BACKGROUND: Limited data exist on the risk factors for acute renal failure (ARF) following cardiac surgery in children with congenital heart disease. This cohort study was conducted to examine this subject, as well as changes in the incidence of ARF from 1993 to 2002, the in-hospital mortality and the time spent in the intensive care unit (ICU).METHODS: One thousand, one hundred and twenty-eight children, operated on for congenital heart disease between 1993 and 2002, were identified from our prospectively collected ICU database to obtain data on potential risk factors.RESULTS: A total of 130 children (11.5%) developed ARF after surgery. A young age [> or =1.0 vs. <0.1 year; odds ratio (OR), 0.23; 95% confidence interval (CI), 0.12-0.46], high Risk Adjusted Classification of Congenital Heart Surgery (RACHS-1) score (OR, 2.72; 95% CI, 1.66-4.45) and cardiopulmonary bypass (CPB) (<90 min vs. none; OR, 2.68; 95% CI, 1.03-6.96; > or =90 min vs. none; OR, 12.94; 95% CI, 5.46-30.67) were independent risk factors for ARF. The risk of ARF decreased during the study period. Children with ARF spent a significantly longer time in the ICU (2-7 days vs. <2 days, P = 0.002; > or =7 days vs. <2 days, P < 0.001) compared with non-ARF patients, and showed increased in-hospital mortality (20% vs. 5%, P < 0.001).CONCLUSION: A young age, high RACHS-1 score and CPB were independent risk factors for ARF after surgical procedures for congenital heart disease in children. The risk of ARF decreased during the study period. Children with severe ARF spent a longer time in the ICU, and the mortality in ARF patients was higher than that in non-ARF patients.
KW - Acute Kidney Injury/epidemiology
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Female
KW - Heart Defects, Congenital/epidemiology
KW - Humans
KW - Incidence
KW - Infant
KW - Male
KW - Renal Dialysis
KW - Risk Factors
U2 - 10.1111/j.1399-6576.2007.01379.x
DO - 10.1111/j.1399-6576.2007.01379.x
M3 - Journal article
C2 - 17944638
VL - 51
SP - 1344
EP - 1349
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 10
ER -
ID: 242715133