SUN-014 IMPACT OF AKI ON OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING

Abstract

Acute kidney injury (AKI) post-coronary artery bypass graft (CABG) is common, but outcomes are not well described. We aimed to investigate the true incidence and risk factors of AKI post Cardiopulmonary bypass (CPB) CABG; in a large inner-city, multi-ethnic, population. Data were analysed in 2413 patients undergoing first time CPB CABG in a large tertiary care, UK hospital. Creatinine measurements were obtained from hospital records, pre-surgery and post-surgery days 1,2,3 and 4. AKI was defined as a rise of serum creatinine 26.4 µmol/L or 50% or 1.5-fold from baseline creatinine. All statistics were done using SPSS 17 and p value<0.05 was considered significant. Baseline patient characteristics (table 1) were: age 67(13) years [median (IQR)], 19% women, 27% diabetics, 68% hypertensives, 59% smokers, BMI 27(6) kg/m2 and heart failure 24%. The incidence of AKI was 23%. Twenty-three percent patients who developed AKI, were older, with higher proportion of blacks, diabetics, hypertensives, higher CCS score (Canadian Cardiovascular Society grading of angina) and higher NYHA class compared to non-AKI patients (table 2). Incidence of AKI was associated with increased length of ICU stay (1[IQR2] vs 1[IQR0] days; p <0.000), length of length of hospital stay (8[IQR5] vs 6[IQR3] days; p<0.000) and increased in-hospital mortality (4.4% vs 0.5%; p<0.000) (table 3). AKI post CABG surgery was common, associated with increased ICU and hospital length of stay, which likely to be associated with increased cost of management; and approximately nine-fold increase in mortality.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)