Tỷ lệ mắc và các yếu tố liên quan đến tổn thương thận cấp (AKI) trong 7 ngày đầu sau phẫu thuật tim mở sử dụng tuần hoàn ngoài cơ thể ngoại vi

Abstract

This retrospective, descriptive study aimed to determine the incidence of Acute Kidney Injury (AKI), defined by KDIGO criteria, within 7 days postoperative and to identify independent risk factors associated with AKI onset in patients undergoing cardiac surgery utilizing peripheral Extracorporeal Circulation (ECC). Data were retrospectively collected from 84 patient records at Hanoi Medical University Hospital between January 2021 and June 2025. AKI diagnosis and staging were based on the KDIGO 2012 criteria. Statistical analysis involved Student’s t-test, Chi-squared test, and multivariate Logistic Regression to ascertain independent predictors. The overall postoperative AKI incidence was 51.2% (43/84 patients). By severity, the incidence rates were: Stage I (20.2%), Stage II (20.2%), and Stage III (10.8%). Multivariate analysis identified four significant independent risk factors: Age > 60 years (OR = 2.8, 95% CI: 1.3 - 6.0, p = 0.008), Prolonged ECC Time > 120 minutes (OR = 3.5, 95% CI: 1.6 - 7.6, p = 0.001), Axillary Cannulation (OR = 2.2, 95% CI: 1.1 - 4.4, p = 0.03), and Elevated Baseline Creatinine > 1.0 mg/dL (OR = 1.9, 95% CI: 1.0 - 3.6, p = 0.045). The overall mortality rate was 6%, and the need for renal replacement therapy was 7%. Mortality in the Stage III AKI group was significantly higher at 22.22% (p < 0.05). The incidence of AKI within the first 7 days following cardiac surgery with peripheral ECC is high. Advanced age, prolonged ECC duration, the use of axillary cannulation, and pre-existing renal dysfunction are critical independent predictors that necessitate early identification and targeted management strategies to improve postoperative outcomes.