Açık kalp ameliyatı geçiren ileri yaştaki hastalarda akut böbrek hasarı için risk faktörleri

Year 2024, , 104 - 109, 28.03.2024

Deniz Sarp Beyazpınar , Mehmet Emir Erol

https://doi.org/10.18663/tjcl.1441211

Abstract

Amaç: Bu çalışmadaki amacımız ileri yaştaki hasta grubunda açık kalp cerrahisi sonrasında akut böbrek yetmezliğinin risk
faktörlerinin belirlenmesi ve doğru hasta seçimi yaparak bu hasta grubunda mortali-te ve morbiditeyi azalmaktır.
Gereç ve Yöntemler: Ocak 2017-aralık 2022, 678 hasta retrospektif olarak incelenmiştir. Hastalar yaşlarına göre < 70 yaş = kontrol grubu, 70–80 yaş = septuagenarian grubu, ve > 80 yaş = octogenarian grubu olarak ayrılmıştır. Yaş, cinsiyet, demografik özellikler, Euroskor, preoperatif serum kreatinin dü-zeyi, postoperatif 1. aydaki serum kreatinin düzeyleri, diyaliz ihtiyacı ve bir yıllık mortalite parametre-leri analiz edilmiştir.
Bulgular: Çalışmaya toplam 206 hasta dahi edilmiştir, bu hastalardan 94'u kontrol grubu (79 erkek), 29 hasta septuagenarian grubu (22 erkek), ve 83 hasta octogenarian grubu (70 erkek). Grupların preo-peratif serum kreatinin düzeylerinde istatistiksel olarak fark vardır. 26 hastanın renal replasman tedavi-si ihtiyacı olmuştur, bunların 6'si kontrol grubunda, 3'u septuagenarian grubunda, ve 17'si ise octoge-narian grubundadır. Renal replasman tedavisi açısından gruplar arasında istatistiksel fark vardır, ve re-nal replasman tedavisi alan hastaların 11 ölmüştür. Toplamda 22 hasta ölmüştür, bunların 4'u kontrol grubunda, 3'u septuagenarian grubunda, ve 15'i ise octogenarian grubundadır.
Sonuç: İleri yaştaki hasta grubunda doğru hasta seçimi, titiz bir cerrahi ve kusursuz miyokardiyal ko-ruma mortalite ve morbiditeyi ciddi azaltmaktadır.

Keywords

Kalp cerrahisi prosedürleri, koroner arter bypass greftleme, böbrek replasman tedavisi, akut böbrek hasarı, ileri yaş

Project Number

KA23/280

Risk factors for acute kidney injury in octogenarians undergoing open-heart surgery: Decrea-sing mortality and morbidity

Abstract

Aim: Our studys goal is, to determine the risk factors for acute kidney injury in octogenarians un-dergoing open-heart surgery to decrease mortality and morbidity by enhancing accurate patient selection in the preoperative period. Material and Methods: Between January 2017-December 2022, 678 patients analyzed retros-pectively. The patient groups were divided as follows: < 70 years old = control group, 70–80 years old = septuagenarian group, and > 80 years old = octogenarian group. Age, sex, ethnicity, Eurosco-re, preoperative serum creatinine levels, postoperative first-month serum creatinine levels, dialy-sis requirements, and first-year mortality parameters were analyzed.
Results: 206 patients has included into study, with 94 patients in the control group (79 male), 29 patients in the septuagenarian group (22 male), and 83 patients in the octogenarian group (70 male). There was a statistically significant difference between the groups based on preoperative serum creatinine. Of the 26 patients requiring renal replacement therapy, 6 were in the control group, 3 were in the septuagenarian group, and 17 were in the octogenarian group. There was a statistically significant difference between groups based on requiring renal replacement therapy, and 11 of the patients requiring renal replacement therapy died. Of the 22 patients who died ove-rall, 4 were in the control group, 3 were in the septuagenarian group, and 15 were in the octoge-narian group.
Conclusion: In the senior patient group, the best approach for optimal patient selection is to ensu-re meticulous surgical technique and myocardial protection.

Keywords

cardiac surgical procedures, coronary artery bypass grafting, renal replacement the-rapy, acute kidney injury, octogenerian

Ethical Statement

E-91694447-604.01.02-262243 sayı ile başvurulan etik kuruldan KA23/280 numara ile etik onay alınılmıştır. Çalışma retrospektif olarak yapılmış olup çalışmada herhangi bir etik ihlal yapılmamıştır.

Supporting Institution

Başkent Üniversitesi Tıp Fakültesi

Project Number

KA23/280

Thanks

Başkent Üniversitesi Kalp Damar Cerrahisi

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