Introduction
Materials and methods
Study population
Methods
Statistics
Results
Characteristics of enrolled patients
Comparison of baseline data between AKI and non-AKI patients
Group | No-AKI | AKI | P-value |
---|---|---|---|
97 | 57 | ||
Age-no., % | |||
≦60 years | 33(34.0%) | 20(35.1%) | 0.893 |
> 60 years | 64 (66.0%) | 37(64.9%) | |
Gender-no., % | 0.169 | ||
Male | 61 (62.9%) | 42 (73.7%) | |
Female | 36 (37.1%) | 15 (26.2%) | |
Diabetes-no., % | 0.704 | ||
No | 60 (61.9%) | 37 (64.9%) | |
Yes | 37 (38.1%) | 20 (35.1%) | |
Hypertension-no., % | 0.492 | ||
No | 27 (27.8%) | 13 (22.8%) | |
Yes | 70 (72.2%) | 44 (77.2%) | |
Previous AF-no., % | 0.487 | ||
No | 89 (91.8%) | 54 (94.7%) | |
Yes | 8 (8.2%) | 3 (5.3%) | |
Previous stroke-no., % | 0.827 | ||
No | 78 (80.4%) | 45 (78.9%) | |
Yes | 19 (19.6%) | 12 (21.1%) | |
Previous MI-no., % | 0.926 | ||
No | 52 (53.6%) | 31 (54.4%) | |
Yes | 45 (46.4%) | 26 (45.6%) | |
CKD-no., % | 0.009 | ||
No | 95 (97.9%) | 50(87.7%) | |
Yes | 2 (2.1%) | 7 (12.3%) | |
Previous HF-no., % | 0.345 | ||
No | 70 (72.2%) | 37 (64.9%) | |
Yes | 27 (27.8%) | 20 (35.1%) | |
WBC count, × 109/L | 5.9 ± 1.4 | 5.9 (5.3, 6.85) | 0.477 |
Neutrophil count, × 109/L | 3.6 ± 1.0 | 3.9 (3.1, 4.6) | 0.101 |
Lymphocyte count, × 109/L | 1.7 (1.5, 2.1) | 1.5 (1.1, 1.9) | 0.005 |
NLR | 2.06 (1.7, 2.56) | 2.63 (1.83, 3.505) | 0.002 |
Hemoglobin, g/L | 129.9 ± 17.7 | 127.5 ± 18.6 | 0.557 |
Albumin, g/L | 40 (37, 42) | 40.4 ± 4.7 | 0.383 |
Serum cystatin C (mg/L) | 1.0 1 (0.875, 1.175) | 1.195 (0.965, 1.385) | 0.003 |
Serum uric acid (umol/L) | 337.2 ± 97.1 | 364.5 ± 105.2 | 0.11 |
Total cholesterol, mmol/L | 4.0 ± 1.0 | 4.1 ± 1.0 | 0.721 |
Triglyceride, mmol/L | 1.35 (0.9875, 1.8825) | 1.515 (1.1375, 2.395) | 0.151 |
LDL, mmol/L | 2.04 (1.7025, 2.805) | 1.92 (1.6825, 2.575) | 0.874 |
hs-TnI, pg/ml | 17.15 (6.525, 82.625) | 21.8 (4.7, 96.2) | 0.917 |
BNP, pg/ml | 118.2 (47.725, 482.175) | 240.9 (108.3, 511.4) | 0.041 |
Serum creatinine, umol/L | 70.9 ± 16.8 | 78 (67, 98.5) | < 0.001 |
Anti-hypertensive drugs, N (%) | |||
ACEI | 39 (40.2%) | 21 (36.8%) | 0.0679 |
ARB | 11 (11.3%) | 9 (15.8%) | 0.428 |
Use of Aspirin, N (%) | 94 (96.9%) | 52 (91.2%) | 0.247 |
Urine output during the cardiopulmonary bypass | 900 (600, 1275) | 1018 ± 563 | 0.803 |
Cardiopulmonary bypass time, min | 114.5 (93, 125) | 125 (108, 130) | 0.004 |
Aortic clamping time, min | 63 (53, 70.5) | 68 (58.5, 81) | 0.019 |
Preoperative LVEF (%)-no., % | < 0.001 | ||
≥ 50 | 66 (94.3%) | 34 (70.8%) | |
< 50 | 4 (5.7%) | 14 (29.2%) |
Relationship between NLR and postoperative AKI after ONCAB
Range of NLR | Tertile1 | Tertile2 | Tertile3 | P value |
---|---|---|---|---|
0.75–1.85 | 1.85–2.56 | 2.61–22.6 | ||
50 | 52 | 52 | ||
Age-no., % | 0.463 | |||
≦60 years | 17 (34.0%) | 21 (40.4%) | 15 (28.8%) | |
> 60 years | 33 (66.0%) | 31 (59.6%) | 37 (71.2%) | |
Gender-no., % | 0.474 | |||
Male | 31 (62.0%) | 34 (65.4%) | 38 (73.1%) | |
Female | 19 (38.0%) | 18 (34.6%) | 14 (26.9%) | |
Diabetes-no., % | 0.817 | |||
No | 32 (64.0%) | 31 (59.6%) | 34 (65.4%) | |
Yes | 18 (36.0%) | 21 (40.4%) | 18 (34.6%) | |
Hypertension-no., % | 0.187 | |||
No | 12 (24.0%) | 18 (34.6%) | 10 (19.2%) | |
Yes | 38 (76.0%) | 34 (65.4%) | 42 (80.8%) | |
Previous AF-no., % | 0.292 | |||
No | 47 (94.0%) | 46 (88.5%) | 50 (96.2%) | |
Yes | 3 (6.0%) | 6 (11.5%) | 2 (3.8%) | |
Previous Stroke-no., % | 0.764 | |||
No | 40 (80.0%) | 43 (82.7%) | 40 (76.9%) | |
Yes | 10 (20.0%) | 9 (17.3%) | 12 (23.1%) | |
Previous MI-no., % | 0.72 | |||
No | 29 (58.0%) | 26 (50.0%) | 28 (53.8%) | |
Yes | 21 (42.0%) | 26 (50.0%) | 24 (46.2%) | |
CKD-no., % | 0.091 | |||
No | 49 (98.0%) | 50 (96.2%) | 46 (88.5%) | |
Yes | 1 (2.0%) | 2 (3.8%) | 6 (11.5%) | |
Previous HF-no., % | 0.336 | |||
No | 32 (64.0%) | 40 (76.9%) | 35 (67.3%) | |
Yes | 18 (36.0%) | 12 (23.1%) | 17 (32.7%) | |
WBC count, × 109/L | 5.5 ± 1.4 | 6.2 ± 1.1 | 6.015 (5.3, 7.4) | 0.003 |
Neutrophil count, × 109/L | 2.9 ± 0.9 | 3.8 ± 0.6 | 4.2 (3.7, 5.3) | < 0.001 |
Lymphocyte count, × 109/L | 2.0 ± 0.5 | 1.7 (1.6, 1.975) | 1.2 (1.1, 1.5) | < 0.001 |
NLR | 1.585 (1.345, 1.7225) | 2.135 (2, 2.2475) | 3.04 (2.7925, 3.6925) | < 0.001 |
Hemoglobin, g/L | 127.2 ± 18.1 | 132.0 ± 15.2 | 127.8 ± 20.3 | 0.411 |
Albumin, g/L | 40 (37, 43) | 40.6 ± 4.1 | 40 (37, 42) | 0.42 |
Serum cystatin C (mg/L) | 1.08 (0.91, 1.2) | 1.0 ± 0.3 | 1.2 ± 0.3 | 0.117 |
Serum uric acid (umol/L) | 349.3 ± 93.2 | 315.5 (266.75, 382.75) | 355.7 ± 91.9 | 0.314 |
Total cholesterol, mmol/L | 4.1 ± 1.2 | 4.1 ± 0.8 | 3.4 (3.0525, 4.2475) | 0.135 |
Triglyceride, mmol/L | 1.33 (1.01, 1.85) | 1.51 (1.01, 2.39) | 1.405 (0.995, 1.965) | 0.693 |
LDL, mmol/L | 1.95 (1.6, 2.885) | 2.31 (1.92, 2.77) | 1.84 (1.5275, 2.51) | 0.059 |
hs-TnI, pg/ml | 27.65 (8.175, 76.475) | 11.5 (5.775, 54.475) | 23.9 (4.3, 123.05) | 0.285 |
BNP, pg/ml | 126 (61.7, 477.2) | 113.95 (44.775, 408.8) | 225.15 (99.55, 583.15) | 0.161 |
Serum creatinine, umol/L | 75.5 (68, 90.25) | 69.8 ± 17.4 | 73 (63.25, 90.5) | 0.027 |
Anti-hypertensive drugs, N (%) | ||||
ACEI | 20 (40%) | 16 (30.8%) | 24 (46.2%) | 0.27 |
ARB | 8 (16%) | 5 (9.6%) | 7 (13.5%) | 0.627 |
Use of aspirin, N (%) | 49 (98%) | 50 (96.2%) | 47 (90.4%) | 0.20 |
Urine output during the cardiopulmonary bypass | 1000 (600, 1300) | 1000 (600, 1500) | 900 (500, 1200) | 0.512 |
Cardiopulmonary bypass time, min | 124 (103.75, 130.25) | 113.5 (90, 125.75) | 121 (100, 126) | 0.069 |
Aortic clamping time, min | 65 (58, 80) | 65.5 (54, 70.75) | 63.8 ± 16.8 | 0.427 |
AKI-no., % | 0.002 | |||
NO | 35 (70.0%) | 39 (75.0%) | 23 (44.2%) | |
YES | 15 (30.0%) | 13 (25.0%) | 29 (55.8%) | |
Preoperative LVEF (%)-no., % | 0.092 | |||
≥ 50 | 35 (92.1%) | 35 (87.5%) | 30 (75.0%) | |
< 50 | 3 (7.9%) | 5 (12.5%) | 10 (25.0%) |
Variable | Univariable | Multivariable | ||
---|---|---|---|---|
OR (95% CI) | P | OR (95% CI) | P | |
CKD(no = 0, yes = 1) | 6.6 (1.3–33.2) | 0.021 | 1.12 (0.052–24.44) | 0.940 |
Lymphocyte count, × 109/L | 0.3 (0.2–0.7) | 0.005 | 0.79 (0.12–5.15) | 0.802 |
NLR | 2.0 (1.3–2.9) | < 0.001 | 4.91 (1.45–16.58) | 0.0104 |
Serum cystatin C (mg/L) | 6.9 (1.7–27.8) | 0.006 | 0.48 (0.01–22.82) | 0.708 |
BNP, pg/ml | 1.0 (1.0–1.0) | 0.161 | 0.999 (0.997–1.001) | 0.406 |
Serum creatinine, umol/L | 1.0 (1.0–1.1) | < 0.001 | 1.054 (1.006–1.105) | 0.026 |
Cardiopulmonary bypass time, min | 1.0 (1.0–1.0) | 0.004 | 1.034 (0.976–1.095) | 0.255 |
Aortic clamping time, min | 1.0 (1.0–1.0) | 0.021 | 1.001 (0.943–1.063) | 0.965 |
LVEF (%) (0 ≥ 50%, 1 < 50%) | 6.8 (2.1–22.2) | 0.002 | 3.751 (0.682–20.638) | 0.129 |
Predictive value of NLR for the occurrence of AKI after ONCAB
Variable | Univariable regression analysis | AUC and optimal threshold | ||
---|---|---|---|---|
OR (95% CI) | P | AUC(95% CI) | Optimal threshold | |
CKD(no = 0, yes = 1) | 1.0 (0.1–10.8) | 0.971 | – | – |
Lymphocyte count, × 109/L | 0.3 (0.1–0.8) | 0.009 | 0.63 (0.53–0.74) | 1.25 |
NLR | 1.9 (1.3–2.9) | 0.002 | 0.64(0.54–0.75) | 3.09 |
Serum cystatin C (mg/L) | 5.9 (1.0–33.8) | 0.048 | 0.63 (0.51–0.75) | 1.13 |
Cardiopulmonary bypass time, min | 1.0 (1.0–1.0) | 0.006 | 0.65 (0.55–0.75) | 114.5 |
Aortic clamping time, min | 1.0 (1.0–1.0) | 0.044 | 0.60 (0.50–0.70) | 69.5 |