Associations Between Base Excess, Alactic Base Excess, and Kidney Function Deterioration in Patients Undergoing Coronary Artery Bypass Grafting Surgery: A Retrospective Cohort Study

IF 2.3 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2025-03-21 DOI:10.1053/j.jvca.2025.03.033

Zheng Li , Da Qian , Yanfei Xia , Kai Kang , Tonghui Feng

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引用次数: 0

Abstract

Objectives

To explore the relationship between base excess (BE), alactic BE (aBE), and the deterioration of kidney function in patients undergoing coronary artery bypass grafting (CABG) surgery.

Design

A retrospective cohort study.

Setting

The Medical Information Mart for Intensive Care IV (MIMIC-IV) database.

Participants

Patients undergoing CABG surgery.

Interventions

None.

Measurements and Main Results

The outcome was kidney function deterioration, including new-onset acute kidney injury (AKI) and increased severity of AKI. Univariate and multivariate logistic regression models were conducted to explore the associations between baseline BE, aBE levels, and kidney function deterioration in patients undergoing CABG surgery. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Covariates were adjusted for, including sepsis, weight, pulse oximetry-derived oxygen saturation, Simplified Acute Physiology Score II, Charlson Comorbidity Index, partial thromboplastin time, vasopressor use, loop diuretics, blood infusions, and acetaminophen use. In total, 5,634 individuals were included who underwent CABG surgery. BE ≤2.61 (OR= 1.22, 95% CI: 1.05-1.41) and aBE ≤1.038 (OR = 1.19, 95% CI: 1.02-1.38) were related to the higher incidence of kidney function deterioration. aBE ≤1.038 (OR = 1.26, 95% CI: 1.01-1.57) was linked to a higher incidence of new onset of AKI. In patients who had AKI at baseline, BE ≤2.61 (OR = 1.88, 95% CI: 1.47-2.41) and aBE ≤1.038 (OR = 1.82, 95% CI: 1.42-2.33) were also related to increased odds of AKI recovery. The relationships between lower BE and aBE and higher odds of kidney function deterioration were also found in those aged ≥65 years, males, patients without chronic kidney disease, patients given vasopressors, and those not administered loop diuretics, nephrotoxic antibiotics, blood infusions, and acetaminophen.

Conclusion

Lower BE and aBE values are associated with an increased risk of kidney function deterioration in patients undergoing CABG surgery. BE and aBE could serve as early markers of kidney injury.

查看原文本刊更多论文

冠状动脉搭桥术患者基底过量、无乳基底过量与肾功能恶化之间的关系：一项回顾性队列研究。

目的：探讨冠状动脉旁路移植术（CABG）患者基底过量（BE）、无乳BE （aBE）与肾功能恶化的关系。设计：回顾性队列研究。环境：重症医疗信息市场IV （MIMIC-IV）数据库。参与者：接受CABG手术的患者。干预措施:没有。测量和主要结果：结果是肾功能恶化，包括新发急性肾损伤（AKI）和AKI严重程度增加。采用单因素和多因素logistic回归模型探讨CABG患者基线BE、aBE水平与肾功能恶化之间的关系。报告了优势比（ORs）和95%置信区间（ci）。协变量包括脓毒症、体重、脉搏氧饱和度、简化急性生理评分II、Charlson合并症指数、部分凝血活素时间、血管加压剂使用、循环利尿剂、血液输注和对乙酰氨基酚使用。总共有5634人接受了冠状动脉搭桥手术。BE≤2.61 （OR= 1.22, 95% CI: 1.05 ~ 1.41）和aBE≤1.038 （OR= 1.19, 95% CI: 1.02 ~ 1.38）与肾功能恶化发生率较高相关。aBE≤1.038 （OR = 1.26, 95% CI: 1.01-1.57）与AKI新发发生率较高相关。在基线时患有AKI的患者中，BE≤2.61 （OR = 1.88, 95% CI: 1.47-2.41）和aBE≤1.038 （OR = 1.82, 95% CI: 1.42-2.33）也与AKI恢复几率增加有关。在年龄≥65岁、男性、无慢性肾病、服用血管加压药物、未服用利尿剂、肾毒性抗生素、输注血液和对乙酰氨基酚的患者中，较低的BE和aBE与较高的肾功能恶化发生率之间也存在相关性。结论：较低的BE和aBE值与接受CABG手术的患者肾功能恶化的风险增加有关。BE和aBE可作为肾损伤的早期标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.