Background: One-stop hybrid coronary revascularization (HCR) combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures simultaneously. Acute kidney injury (AKI) is a common complication after CABG or PCI. This study explored the risk factors for developing AKI after one-stop HCR.
Methods: A total of 123 consecutive patients who underwent one-stop HCR between April 2018 and November 2020 were included in this single-center retrospective study. Postoperative AKI was observed in 11 patients (the AKI group), and 112 patients did not develop postoperative AKI (the non-AKI group). Baseline characteristics and perioperative variables were extracted from the electronic medical records and statistically analyzed.
Results: Postoperative AKI occurred in 11 (8.9%) patients. Compared to patients who did not develop AKI, patients in the AKI group were older (71.0±9.5 vs. 64.1±9.2 years, P=0.019), had higher preoperative creatinine levels (92.6±16.8 vs. 69.8±14.4 mmol/L, P<0.001), experienced a greater volume of postoperative drainage on the first day {850 mL [410, 1,500] vs. 500 mL [321, 700], P=0.045}, had a higher proportion of chronic renal insufficiency (eGFR <60 mL/min/1.73 m2) (36.4% vs. 7.1%, P=0.012), and had more perioperative transfusions (63.6% vs. 22.3%, P=0.007). Multivariate logistics analyses revealed that advanced age [odds ratio (OR) 5.44, P=0.014] and perioperative transfusions (OR 4.62, P=0.028) were independent risk factors for developing AKI after one-stop HCR.
Conclusions: One-stop HCR did not increase the incidence of postoperative AKI in our center. Advanced age (≥75 years) and perioperative transfusions were independent risk factors for developing AKI after one-stop HCR. Further studies need to be conducted to confirm the risk factors of AKI after HCR procedures.
Keywords: Coronary artery bypass grafting (CABG); acute kidney injury (AKI); hybrid coronary revascularization (HCR); percutaneous coronary intervention (PCI); risk factor.