ArticleJournal of clinical medicine2026
Preoperative Anaemia, Renal Function, and Operative Factors in Acute Kidney Injury and Mortality After Cardiac Surgery with a Prolonged ICU Stay: A Retrospective Cohort Study.
Article in Journal of clinical medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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1 citing paper in PubMed.
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury (AKI) is one of the more serious complications following cardiac surgery, consistently linked to prolonged mechanical ventilation and higher in-hospital mortality. This study examined whether preoperative anaemia and impaired renal function are associated with AKI and death in a high-risk cardiac-surgery cohort requiring extended postoperative ICU monitoring and how these associations behave after adjustment for procedure type and intraoperative variables.
methodsIn this single-centre retrospective cohort study, we screened 950 patients admitted to a cardiothoracic ICU between January 2018 and January 2024. After standard exclusion criteria and an audit of operative records, 553 cardiac-surgery patients formed the principal analysis cohort. AKI was defined by KDIGO criteria using serial postoperative serum-creatinine measurements during the first 7 days. Multivariable logistic regression for AKI and in-hospital mortality was built sequentially: Model A (baseline only); Model B (+procedure type); and Model C (+intraoperative variables: aortic cross-clamp time, intraoperative RBC units, and intraoperative inotrope use). Calibration was assessed by the Hosmer-Lemeshow test. Total cardiopulmonary bypass duration was not separately captured in the institutional database and is disclosed as a limitation.
resultsAKI occurred in 174 of 553 patients (31.5%), and in-hospital mortality was 16.6% (92/553). Patients with AKI were older (median 77 vs. 68 years,
conclusionsIn cardiac-surgery patients with a prolonged ICU stay, AKI is independently associated with in-hospital mortality even after adjustment for operative variables. The univariable association between preoperative haemoglobin and AKI is attenuated after adjustment for procedure type and intraoperative transfusion exposure, suggesting confounding or mediation by operative and case-mix factors rather than an independent direct association. The contribution of this analysis is aetiological/analytical rather than predictive (modest discrimination, AUROC 0.67 for AKI), and findings should be interpreted within the selected high-risk ICU ≥ 72 h population.
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