Abstract 66: Factors Associated with Acute Kidney Injury in Patients Treated with Therapeutic Hypothermia After Cardiac Arrest
Purpose: Acute kidney injury (AKI) caused renal ischemic-reperfusion injury occurs in patients after cardiac arrest. AKI is a consistent and powerful predictor of in-hospital mortality, and is associated with an increase in hospital length of stay, hospital costs, and resource utilization. We investigate risk factors associated with AKI after cardiac arrest treated with TH.
Methods: We performed an observational cohort study of patients aged more than 18 years, who were successfully resuscitated following cardiac arrest and treated with TH by our institutional protocol from March 1, 2009 to May 31, 2012. The patients who were previous end-stage renal disease or pre-existing AKI on renal replacement therapy, and have no available biochemical results within 12hours after cardiac arrest were excluded in this study. AKI was categorized using the peak and estimated baseline serum creatinine, into: (i) no AKI, (ii) risk of AKI, (iii) Kidney injury, (iv) Kidney failure; according to the RIFLE criteria.
Result: 136 patients after cardiac arrest were treated with TH during study period. Among them 130 patients were included in the final analysis. 27 of 130 patients (20.7%) had AKI class injury/failure during first 3days of hospitalization after cardiac arrest. On multivariate binary logistic regression analysis, the event of cardiogenic shock(OR, 5.949, 95% C.I. 1.401-25.271, p=0.016), higher serum lactate level at 6h(OR, 1.335, 95% C.I. 1.023-1.744, p=0.034) after ROSC and the cumulative dose of epinephrine during resuscitation(OR, 4.347, 95% C.I. 1.040-18.164, p=0.044) were independently associated with AKI.
Conclusion: The development of AKI after CA was associated with hemodynamic status during therapeutic hypothermia and serum lactate after ROSC. Theses associated risk factors for AKI after CA could be useful in clinical decision making, resources utilization, and outcome prediction.
Author Disclosures: S. Kim: None. C. Youn: None. S. Oh: None. K. Park: None.
- © 2014 by American Heart Association, Inc.