Acute Kidney Injury After Thoracic Aortic Surgery

All articles of this category (opens in new window) Background: Postoperative acute kidney injury (AKI) is known to be a driving factor for prolonged hospital stay and mortality after aortic surgery. Thus, identification of risk factors predicting the postoperative occurrence of AKI is of utmost importance. Methods: From January 2010 to November 2023, 1,623 patients without end-stage renal disease underwent aortic surgery at our center. Independent risk factors for AKI (serum creatinine >3× base level) after thoracic aortic surgery were identified using multivariable logistic regression analysis with backward elimination (Wald). Results: Median age was 64 (IQR: 54–73) years, with 66.2% male patients. EuroSCORE II was 4.5% (IQR: 2.6–9.2%). Acute aortic syndrome (AAS), chronic aortic syndrome, and aortic aneurysm were present in 23.0, 5.6, and 71.4% of patients, respectively, and endocarditis was present in 2.3%. Concomitant nonaortic/AV procedures were necessary in 318 patients (19.6%), and 781 patients (48.1%) received a hemiarch, total arch, or frozen elephant trunk procedure. Postoperative AKI occurred in 218 (13.4%) patients, with the necessity of dialysis in 77 (4.7%) patients. Thirty-day mortality was 6.8% and was significantly higher in patients with postoperative AKI vs. patients without AKI (20.6% vs. 4.7%, p < 0.001). In multivariable regression analysis, including 17 covariables (sex, age >70 years, prior cardiac/aortic surgery, HTAD, arterial hypertension, diabetes, peripheral vascular disease, atrial fibrillation, AAS, CKD, LV-function