scholarly journals Preoperative identification of cardiac surgery patients at risk of receiving a platelet transfusion: The Australian Cardiac Surgery Platelet Transfusion ( ACSePT ) risk prediction tool

Transfusion ◽  
2020 ◽  
Vol 60 (10) ◽  
pp. 2272-2283
Author(s):  
Andrew W. J. Flint ◽  
Michael Bailey ◽  
Christopher M. Reid ◽  
Julian A. Smith ◽  
Lavinia Tran ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiac Surgery ◽  
Risk Prediction ◽  
Platelet Transfusion ◽  
Prediction Tool ◽  
Patients At Risk

scholarly journals The Papworth Bleeding Risk Score: a stratification scheme for identifying cardiac surgery patients at risk of excessive early postoperative bleeding

2011 ◽  
Vol 39 (6) ◽  
pp. 924-930 ◽  
Author(s):  
Alain Vuylsteke ◽  
Christina Pagel ◽  
Caroline Gerrard ◽  
Brian Reddy ◽  
Samer Nashef ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiac Surgery ◽  
Risk Score ◽  
Postoperative Bleeding ◽  
Bleeding Risk ◽  
Patients At Risk

scholarly journals Stratifying risk of acute kidney injury in pre and post cardiac surgery patients using a novel biomarker-based algorithm and clinical risk score

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
William T. McBride ◽  
Mary Jo Kurth ◽  
Gavin McLean ◽  
Anna Domanska ◽  
John V. Lamont ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Score ◽  
Kidney Injury ◽  
Predictive Ability ◽  
Clinical Risk Score ◽  
Clinical Risk ◽  
Patients At Risk ◽  
Post Cardiac Surgery

AbstractAcute kidney injury (AKI) following cardiac surgery significantly increases morbidity and mortality risks. Improving existing clinical methods of identifying patients at risk of perioperative AKI may advance management and treatment options. This study investigated whether a combination of biomarkers and clinical factors pre and post cardiac surgery could stratify patients at risk of developing AKI. Patients (n = 401) consecutively scheduled for elective cardiac surgery were prospectively studied. Clinical data was recorded and blood samples were tested for 31 biomarkers. Areas under receiver operating characteristic (AUROCs) were generated for biomarkers pre and postoperatively to stratify patients at risk of AKI. Preoperatively sTNFR1 had the highest predictive ability to identify risk of developing AKI postoperatively (AUROC 0.748). Postoperatively a combination of H-FABP, midkine and sTNFR2 had the highest predictive ability to identify AKI risk (AUROC 0.836). Preoperative clinical risk factors included patient age, body mass index and diabetes. Perioperative factors included cardio pulmonary bypass, cross-clamp and operation times, intra-aortic balloon pump, blood products and resternotomy. Combining biomarker risk score (BRS) with clinical risk score (CRS) enabled pre and postoperative assignment of patients to AKI risk categories. Combining BRS with CRS will allow better management of cardiac patients at risk of developing AKI.

Improving the Identification of Patients at Risk of Postoperative Renal Failure after Cardiac Surgery

2006 ◽  
Vol 104 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Duminda N. Wijeysundera ◽  
Keyvan Karkouti ◽  
W Scott Beattie ◽  
Vivek Rao ◽  
Joan Ivanov
Keyword(s):  
At Risk ◽  
Logistic Regression ◽  
Renal Function ◽  
Cardiac Surgery ◽  
Renal Insufficiency ◽  
Care Center ◽  
Tertiary Care ◽  
Receiver Operating Curve ◽  
Alternative Measure ◽  
Patients At Risk

Background Preoperative renal insufficiency is an important predictor of the need for postoperative renal replacement therapy (RRT). Serum creatinine (sCr) has a limited ability to identify patients with preoperative renal insufficiency because it varies with age, sex, and muscle mass. Calculated creatinine clearance (CrCl) is an alternative measure of renal function that may allow better estimation of renal reserve. Methods Data were prospectively collected for consecutive patients who underwent cardiac surgery requiring cardiopulmonary bypass at a tertiary care center. The relation between CrCl (Cockcroft-Gault equation) and RRT was initially described using descriptive statistics, logistic regression, and receiver operating curve analysis. Based on these analyses, preoperative renal insufficiency was defined as CrCl of 60 ml/min or less. Preoperative renal function was classified as moderate insufficiency (sCr > 133 microM), mild insufficiency (100 microM < sCr < or = 133 microM), occult insufficiency (sCr < or = 100 microM and CrCl < or = 60 ml/min), or normal function (sCr < or = 100 microM and CrCl > 60 ml/min). The independent association of preoperative renal function with RRT was subsequently determined using multiple logistic regression. Results Of the 10,751 patients in the sample, 137 (1.2%) required postoperative RRT. Approximately 13% of patients with normal sCr had occult renal insufficiency. Occult renal insufficiency was independently associated with RRT (odds ratio, 2.80; 95% confidence interval, 1.39-5.33). The magnitude of this risk was similar to patients with mild renal insufficiency (P = 0.73). Conclusions The inclusion of a simple CrCl-based criterion in preoperative assessments may improve identification of patients at risk of needing postoperative RRT.

scholarly journals Reduction in acute kidney injury post cardiac surgery using balanced forced diuresis: a randomized, controlled trial

2020 ◽  
Author(s):  
Heyman Luckraz ◽  
Ramesh Giri ◽  
Benjamin Wrigley ◽  
Kumaresan Nagarajan ◽  
Eshan Senanayake ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Confidence Interval ◽  
Kidney Injury ◽  
Control Group ◽  
Binary Logistic Regression Analysis ◽  
Number Needed To Treat ◽  
Forced Diuresis ◽  
Patients At Risk

Abstract OBJECTIVES Our goal was to investigate the efficacy of balanced forced diuresis in reducing the rate of acute kidney injury (AKI) in cardiac surgical patients requiring cardiopulmonary bypass (CPB), using the RenalGuard® (RG) system. METHODS Patients at risk of developing AKI (history of diabetes and/or anaemia; estimated glomerular filtration rate 20–60 ml/min/1.73 m2; anticipated CPB time >120 min; log EuroSCORE > 5) were randomized to the RG system group (n = 110) or managed according to current practice (control = 110). The primary end point was the development of AKI within the first 3 postoperative days as defined by the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage renal disease) criteria. RESULTS There were no significant differences in preoperative and intraoperative characteristics between the 2 groups. Postoperative AKI rates were significantly lower in the RG system group compared to the control group [10% (11/110) vs 20.9% (23/110); P = 0.025]. This effect persisted even after controlling for a number of potential confounders (odds ratio 2.82, 95% confidence interval 1.20–6.60; P = 0.017) when assessed by binary logistic regression analysis. The mean volumes of urine produced during surgery and within the first 24 h postoperatively were significantly higher in the RG system group (P < 0.001). There were no significant differences in the incidence of blood transfusions, atrial fibrillation and infections and in the median duration of intensive care unit stays between the groups. The number needed to treat with the RG system to prevent AKI was 9 patients (95% confidence interval 6.0–19.2). CONCLUSIONS In patients at risk for AKI who had cardiac surgery with CPB, the RS RG system significantly reduced the incidence of AKI and can be used safely and reproducibly. Larger studies are required to confirm cost benefits. Clinical trial registration number: NCT02974946

scholarly journals β blockers for patients at risk of cardiac events during non-cardiac surgery

BMJ ◽  
2005 ◽  
Vol 331 (7522) ◽  
pp. 919-920 ◽  
Author(s):  
Stephen Bolsin ◽  
Mark Colson
Keyword(s):  
At Risk ◽  
Cardiac Surgery ◽  
Cardiac Events ◽  
Patients At Risk ◽  
Β Blockers
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