ArticleAnnals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia2026
Association between Creatinine Trajectories and All-Cause Mortality in Elderly Patients after Cardiac Surgery: A Retrospective Cohort Study Based on MIMIC-IV.
Article in Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeConventional monitoring of serum creatinine at isolated time points is suboptimal for reflecting disease progression. We therefore evaluated the prognostic value of distinct serum creatinine trajectories for predicting all-cause mortality in this patient population.
methodsWe conducted a retrospective cohort study of elderly patients undergoing cardiac surgery, using data from the Medical Information Mart for Intensive Care database (MIMIC-IV). Kaplan-Meier analysis compared survival outcomes among the identified classes. Multivariable logistic and Cox proportional hazards models determined the independent associations of these trajectories with in-hospital and 1-year all-cause mortality.
resultsA total of 5145 patients undergoing cardiac surgery were included in the analysis. Three distinct creatinine trajectories were identified: low-stable (Class 1), persistent-increase (Class 2), and transient-increase (Class 3). Class 1 had the lowest in-hospital and 1-year mortality rates. Using Class 1 as the reference, Class 2 demonstrated the highest mortality risk, followed by Class 3.
conclusionDistinct creatinine trajectory patterns conferred independent prognostic value for postoperative outcomes in elderly patients after cardiac surgery. A persistently high trajectory was independently associated with significantly increased mortality compared to the low-stable trajectory class.
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