Abstract 20413: Relationship Between Early Cardiac Catheterization following Cardiac Arrest Resuscitation and Acute Kidney Injury
Background: A survival benefit has been demonstrated when survivors of cardiac arrest receive bundled post-arrest care, including early cardiac catheterization (ECC). Cardiac arrest and ECC have both been associated with acute kidney injury (AKI). However, despite this risk, it is poorly understood whether ECC following arrest resuscitation presents cumulative risk for AKI.
Hypothesis: We sought to test the relationship between ECC and development of AKI in post-cardiac arrest patients.
Methods: Adult patients with non-traumatic arrest from one hospital system were evaluated between 2005 and 2015. Patient demographics, arrest characteristics, and post-arrest care information was collected. The primary outcome of interest was AKI development (using well-established KDIGO criteria) over the first 5 days post-arrest. Baseline creatinine (CR) was measured as the first CR post-cardiac arrest within 6 hours. For patients who received ECC (within 5 days of arrest), pre-ECC values were measured at the closest value to ECC in the 24 hours prior to ECC, and post-ECC values were measured as the closest value to 72 hours post-ECC (between 48-84 hours). Time-sequenced matched CR values were also obtained for patients without ECC. We measured baseline hemoglobin (Hgb) to assess for pre-existing anemia as the earliest value in the first 24 hours of admission.
Results: We included 353 post-arrest patients with serial CR values. Mean age was 61±16 years, 60% were male, 42% received targeted temperature management, 43% had initial rhythm of VF/VT, and 68% had ECC. Median baseline CR was 1.6 (IQR: 1.1, 2.5). In regression analysis, controlling for baseline CR, pre-ECC CR, age, initial rhythm, location of arrest, and Hgb, we found no significant relationship between ECC and kidney injury (OR: 0.66 (95% CI: 0.37-1.19)).
Conclusions: ECC within 7 days of arrest does not appear to increase risk of AKI in this population.
Author Disclosures: E.L. Mutter: None. A.V. Grossestreuer: Research Grant; Significant; American Heart Association. M.G. Shashaty: None. T. Miano: None. D.F. Gaieski: None. B.S. Abella: Research Grant; Significant; NHLBI, PCORI, American Heart Association, CR BARD, Medtronic. Honoraria; Modest; CR BARD, Physio-Control. Consultant/Advisory Board; Modest; IKARIA Inc., Cardioready.
- © 2016 by American Heart Association, Inc.