scholarly journals 070 ACUTE KIDNEY INJURY IN CORONARY CARE UNIT: PREVALENCE, AETIOLOGIES AND OUTCOMES

2017 ◽  
Vol 2 (4) ◽  
pp. S34
Author(s):  
M.H. Tan ◽  
S.K. Glendon Lau ◽  
W.H. Han ◽  
N.T. Ross ◽  
R. Visvanathan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Care Unit ◽  
Kidney Injury ◽  
Coronary Care

scholarly journals Anion Gap Was Associated with Inhospital Mortality and Adverse Clinical Outcomes of Coronary Care Unit Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Tienan Sun ◽  
Chenghui Cai ◽  
Hua Shen ◽  
Jiaqi Yang ◽  
Qianyun Guo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Outcomes ◽  
Coronary Care Unit ◽  
Kidney Injury ◽  
Anion Gap ◽  
Independent Effect ◽  
Binary Logistic Regression Analysis ◽  
Inhospital Mortality ◽  
All Cause Mortality ◽  
Coronary Care

Background. Anion gap (AG) has been proved to be associated with prognosis of many cardiovascular diseases. This study is aimed at exploring the association of AG with inhospital all-cause mortality and adverse clinical outcomes in coronary care unit (CCU) patients. Method. All data of this study was extracted from Medical Information Mart for Intensive Care III (MIMIC-III, version 1.4) database. All patients were divided into four groups according to AG quartiles. Primary outcome was inhospital all-cause mortality. Lowess smoothing curve was drawn to describe the overall trend of inhospital mortality. Binary logistic regression analysis was performed to determine the independent effect of AG on inhospital mortality. Result. A total of 3593 patients were enrolled in this study. In unadjusted model, as AG quartiles increased, inhospital mortality increased significantly, OR increased stepwise from quartile 2 (OR, 95% CI: 1.01, 0.74-1.38, P=0.958) to quartile 4 (OR, 95% CI: 2.72, 2.08-3.55, P<0.001). After adjusting for possible confounding variables, this association was attenuated, but still remained statistically significant (quartile 1 vs. quartile 4: OR, 95% CI: 1.02, 0.72-1.45 vs. 1.49, 1.07-2.09, P=0.019). Moreover, CCU mortality (P<0.001) and rate of acute kidney injury (P<0.001) were proved to be higher in the highest AG quartiles. Length of CCU (P<0.001) and hospital stay (P<0.001) prolonged significantly in higher AG quartiles. Maximum sequential organ failure assessment score (SOFA) (P<0.001) and simplified acute physiology score II (SAPSII) (P<0.001) increased significantly as AG quartiles increased. Moderate predictive ability of AG on inhospital (AUC: 0.6291), CCU mortality (AUC: 0.6355), and acute kidney injury (AUC: 0.6096) was confirmed. The interactions were proved to be significant in hypercholesterolemia, congestive heart failure, chronic lung disease, respiratory failure, oral anticoagulants, Beta-blocks, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), and vasopressin treatment subgroups. Conclusion. AG was an independent risk factor of inhospital all-cause mortality and was associated with adverse clinical outcomes in CCU patients.

scholarly journals Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study

PLoS ONE ◽  
2012 ◽  
Vol 7 (2) ◽  
pp. e32328 ◽  
Author(s):  
Tien-Hsing Chen ◽  
Chih-Hsiang Chang ◽  
Chan-Yu Lin ◽  
Chang-Chyi Jenq ◽  
Ming-Yang Chang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Coronary Care Unit ◽  
Kidney Injury ◽  
Coronary Care

scholarly journals Neutrophil Percentage to Albumin Ratio Was Associated with Clinical Outcomes in Coronary Care Unit Patients

2021 ◽  
Author(s):  
Chenghui Cai ◽  
Tienan Sun ◽  
Fang Zhao ◽  
Jun Ma ◽  
Xin Pei ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Coronary Care Unit ◽  
Kidney Injury ◽  
Roc Curves ◽  
Albumin Ratio ◽  
Cumulative Survival ◽  
Kaplan Meier ◽  
Neutrophil Percentage ◽  
Coronary Care

Abstract Background: Neutrophil percentage to albumin ratio (NPAR) was proved to be correlated with the prognosis of a variety of diseases. The purpose of this study was to explore the effect of NPAR on the prognosis of coronary care unit (CCU) dpatients.Method: All data of this study was extracted from Medical Information Mart for Intensive Care III (MIMIC-III, version1.4) database. All patients were divided into four groups according to NPAR quartiles. Primary outcome was in-hospital mortality and secondary outcomes were 30-day mortality, 365-day mortality, length of CCU stay, length of hospital stay, acute kidney injury, renal replacement therapy. Multivariable binary logistic regression analysis was performed to confirm the independent effect of NPAR. Subgroup analysis was used to determine the effect of NPAR on in-hospital mortality in different subgroups. Receiver-operating characteristic (ROC) curves were applied to evaluate the ability of NPAR to predict in-hospital mortality. Kaplan–Meier curves were built to compare cumulative survival of different groups.Result: 2364 CCU patients were enrolled in this study. In-hospital mortality rate increased significantly as NPAR quartiles increased (P < 0.001). In multivariable logistic regression, NPAR was proved to be independently associated with in-hospital mortality (Quartile 4 vs Quartile 1: OR, 95% CI: 1.80, 1.19-2.72, P=0.005, P for trend = 0.001). Moderate ability of NPAR to predict in-hospital mortality was demonstrated through ROC curves, the AUC of NPAR was 0.653 (P<0.001), which is better than PLR (P<0.001), neutrophil (P<0.001) but lower than SOFA(P=0.046) and SAPS II (P<0.001). Subgroup analysis did not find obvious interaction in most subgroups. Moreover, Kaplan-Meier curves showed that as NPAR quartiles increased, 30-day (Log rank, P<0.001) and 365-day (Log rank, P<0.001) cumulative survival decreased significantly. NPAR was also proved to be independently associated with acute kidney injury (Quartile 4 vs Quartile 1: OR, 95% CI: 1.57, 1.19-2.07, P=0.002, P for trend = 0.001). Length of CCU and hospital stay were prolonged significantly in higher NPAR quartiles.Conclusion: NPAR was an independent risk factor of in-hospital mortality in CCU patients and had a moderate ability to predict in-hospital mortality.

scholarly journals Acute kidney disease and acute kidney injury biomarkers in coronary care unit patients

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yih-Ting Chen ◽  
Chang-Chyi Jenq ◽  
Cheng-Kai Hsu ◽  
Yi-Ching Yu ◽  
Chih-Hsiang Chang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Coronary Care Unit ◽  
Kidney Injury ◽  
Acute Kidney Disease ◽  
Coronary Care

Abstract 13306: Combined Assessment of Acute Kidney Injury and Increased Plasma Concentration of D-dimer Is Useful for Evaluating 1-year Mortality in Patients Hospitalized to Coronary Care Units

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Shigeru Matsui ◽  
Junichi Ishii ◽  
Ryuunosuke Okuyama ◽  
Hiroshi Takahashi ◽  
Hideki Kawai ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Relative Risk ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Absolute Increase ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
Coronary Care ◽  
D Dimer

Background: Acute kidney injury (AKI) detected after admission to coronary care unit (CCU) is associated with very poor outcomes. We prospectively investigated the prognostic value of a combination of AKI and high plasma D-dimer levels for 1-year mortality in patients hospitalized to CCUs. Methods: D-dimer, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitive C-reactive protein (hsCRP) levels were measured in 1228 patients on admission to CCUs, of whom 56% had decompensated heart failure and 38% had acute coronary syndrome. AKI was defined as an increase of >25% in creatinine from baseline or an absolute increase of ≥0.5 mg/dL within 48 h after admission. Left ventricular ejection fraction (LVEF) and E/e’ ratio were estimated using echocardiography with tissue Doppler imaging. Results: AKI was detected in 163 (13%) patients. During 1-year follow-up period, there were 149 (12%) deaths. The patients who died were older (median: 77 vs. 73 years; p < 0.0001) and exhibited higher D-dimer (2.7 vs. 1.3 μg/mL; p < 0.0001), NT-proBNP (5495 vs. 1525 pg/mL; p < 0.0001), and hsCRP levels (0.92 vs, 0.26 mg/L; p < 0.0001) and E/e’ ratio (15.0 vs. 13.2; p = 0.006). They also had a higher incidence of AKI (26% vs. 12%; p < 0.0001) and lower LVEF (39% vs. 49%; p < 0.0001) and estimated glomerular filtration rate (45 vs. 62 mL/min/1.73 m 2 ; p < 0.0001) than patients who survived. Multivariate Cox regression analysis, including 12 clinical, biochemical, and echocardiographic variables, identified AKI (relative risk: 1.79; p = 0.008) and increased D-dimer level (relative risk: 1.83 per 10-fold increment; p = 0.002) as independent predictors of 1-yeart mortality. The combined assessment of AKI and D-dimer quartiles was significantly associated with 1-year mortality rates (Figure). Conclusions: The combined assessment of AKI and high D-dimer levels may be useful for evaluating the risk of 1-year mortality in patients admitted to CCUs.

scholarly journals Urinary Biomarkers Improve the Diagnosis of Intrinsic Acute Kidney Injury in Coronary Care Units

Medicine ◽  
2015 ◽  
Vol 94 (40) ◽  
pp. e1703 ◽  
Author(s):  
Chih-Hsiang Chang ◽  
Chia-Hung Yang ◽  
Huang-Yu Yang ◽  
Tien-Hsing Chen ◽  
Chan-Yu Lin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Urinary Biomarkers ◽  
Coronary Care ◽  
Coronary Care Units
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