Evidence map›Paper›PMID 26296273›Full record

Observational studyThe Annals of thoracic surgery2015

Nadir Hematocrit on Bypass and Rates of Acute Kidney Injury: Does Sex Matter?

Michelle C Ellis, Theron A Paugh, Timothy A Dickinson, John Fuller, Jeffrey Chores, Gaetano Paone, Michael Heung, Karsten Fliegner, Andrew L Pruitt, Himanshu J Patel and 4 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Annals of thoracic surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Michelle C EllisDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
Theron A PaughDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
Timothy A DickinsonSpecialty Care, Nashville, Tennessee.
John FullerSt. John Providence Health System Detroit Hospitals, Detroit, Michigan.
Jeffrey ChoresSt. John Providence Health System Detroit Hospitals, Detroit, Michigan.
Gaetano PaoneDivision of Cardiac Surgery, Henry Ford Hospital, Detroit, Michigan.
Michael HeungDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
Karsten FliegnerGenesys Heart Institute, Grand Blanc, Michigan.
Andrew L PruittMichigan Heart and Vascular Institute, St. Joseph Mercy Hospital, Ann Arbor, Michigan.
Himanshu J PatelDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
Min ZhangDepartment of Biostatistics, University of Michigan, Ann Arbor, Michigan.
Richard L PragerDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
Donald S LikoskyDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan. Electronic address: likosky@med.umich.edu.
PERForm Registry and the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative

Funding

Optimizing Prevention of Healthcare-Acquired Infections After Cardiac SurgeryR01HS022535 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIKOSKY, DONALD S · 2013 to 2016
$1.5M
Determinants of Blood Transfusions after Cardiac SurgeryR03HS022909 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIKOSKY, DONALD S · 2014 to 2015
$100k
AHRQ HHS R01 HS022535AHRQ HHS R01HS022535AHRQ HHS R03 HS022909AHRQ HHS R03HS022909
6 · The paper itself

Abstract

backgroundReports have associated nadir hematocrit (Hct) on cardiopulmonary bypass with the occurrence of renal dysfunction. Recent literature has suggested that women, although more often exposed to lower nadir Hct, have a lower risk of postoperative renal dysfunction. We assessed whether this relationship held across a large multicenter registry.

methodsWe undertook a prospective, observational study of 15,221 nondialysis-dependent patients (10,376 male, 68.2%; 4,845 female, 31.8%) undergoing cardiac surgery between 2010 and 2014 across 26 institutions in Michigan. We calculated crude and adjusted OR between nadir Hct during cardiopulmonary bypass and stage 2 or 3 acute kidney injury (AKI), and tested the interaction of sex and nadir Hct. The predicted probability of AKI was plotted separately for men and women.

resultsNadir Hct less than 21% occurred among 16.6% of patients, although less commonly among men (9.5%) than women (31.9%; p < 0.001). Acute kidney injury occurred among 2.7% of patients, with small absolute differences between men and women (2.6% versus 3.0%, p = 0.20). There was a significant interaction between sex and nadir Hct (p = 0.009). The effect of nadir Hct on AKI was stronger among male patients (adjusted odds ratio per 1 unit decrease in nadir Hct 1.10, 95% confidence interval: 1.05 to 1.13) than female patients (adjusted odds ratio 1.01, 95% CI: 0.96, 1.06).

conclusionsLower nadir Hct was associated with an increased risk of AKI, and the effect appears to be stronger among men than women. Understanding of the mechanism underlying this association remains uncertain, although these results suggest the need to limit exposure to lower nadir Hct, especially for male patients.

Indexed as

Postoperative ComplicationsRegistriesAcute Kidney InjuryAgedCardiopulmonary BypassFemaleHematocritHumansIncidenceMaleMichiganMiddle AgedOdds RatioPrognosisProspective StudiesRetrospective Studies

Identifiers

PMID26296273
PMCPMC6817808

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.