Table_1_The Effect of Coronary Angiography Timing on Cardiac Surgery Associated Acute Kidney Injury Incidence and Prognosis.DOCX

Introduction: Acute kidney injury has been identified as a common complication of cardiac surgery. To date, the effect of the time interval from coronary angiography to cardiac surgery on postoperative acute kidney injury is still controversial. The aim of this study was to investigate the relationship between the timing of coronary angiography and cardiac surgery associated acute kidney injury.
Methods: Eight hundred thirteen patients who underwent coronary angiography and cardiac surgery successively from January 2017 to December 2018 were included in this retrospective cohort study. We applied multivariate logistic regression, propensity score analysis, and subgroup analysis to evaluate the association between the time interval and postoperative acute kidney injury incidence and prognosis. Meta-analysis was conducted to verify the results.
Results: The overall incidence of the cardiac surgery associated acute kidney injury was 28.8%. Age (OR = 1.046, 95%CI: 1.017–1.075), cardiopulmonary bypass (OR = 3.439, 95%CI: 1.316–8.986) and diabetes (OR = 2.522, 95%CI: 1.439–4.417) were found to be independent risk factors of postoperative acute kidney injury in multivariate logistic regression and propensity score analysis. Undergoing cardiac surgery within 7 days after coronary angiography was not associated with increased incidence of postoperative acute kidney injury or worse prognosis. Meta-analysis obtained consistent results.
Conclusions: The time interval shorter than 7 days had no influence on cardiac surgery associated acute kidney injury incidence and prognosis. The decision of delaying the surgery should be made after comprehensive evaluation of the patient.

引言：急性肾损伤（Acute Kidney Injury）已被确认为心脏外科手术（Cardiac Surgery）的常见并发症。迄今为止，冠状动脉造影术（Coronary Angiography）至心脏外科手术的时间间隔对术后急性肾损伤的影响仍存在争议。本研究旨在探讨冠状动脉造影时机与心脏外科手术相关急性肾损伤之间的关联。
方法：本回顾性队列研究纳入了2017年1月至2018年12月期间先后接受冠状动脉造影术及心脏外科手术的813例患者。我们采用多因素logistic回归、倾向得分分析及亚组分析，评估该时间间隔与术后急性肾损伤发生率及预后的关联，并通过Meta分析验证研究结果。
结果：心脏外科手术相关急性肾损伤的总体发生率为28.8%。多因素logistic回归及倾向得分分析结果显示，年龄（比值比OR=1.046，95%置信区间CI：1.017–1.075）、体外循环（Cardiopulmonary Bypass）及糖尿病（Diabetes）为术后急性肾损伤的独立危险因素。在冠状动脉造影术后7天内接受心脏外科手术的患者，其术后急性肾损伤发生率并未升高，预后亦未恶化。Meta分析得到了一致的研究结果。
结论：时间间隔短于7天并不会对心脏外科手术相关急性肾损伤的发生率及预后产生影响。若考虑延迟手术，需对患者进行综合评估后再作出决策。