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Clinical risk factors for the prediction of acute kidney injury post cardiac resynchronization therapy
Session:
Painel 5- Arritmologia 4
Speaker:
Alexander Marschall
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.3 Cardiac Resynchronization Therapy
Session Type:
Posters
FP Number:
---
Authors:
Alexander Marschall; Hugo del Castillo Carnevalli; José Carlos de la Flor Merino; Davíd Martí Sánchez; María de Fatima Goncalves Sánchez; Montserrat Torres López; Concepción Fernández Pascual; Salvador Álvarez Antón; Ricardo Concepción Suárez; Dámaris Carballeira Puentes
Abstract
<p>Background: There is only limited data available on the occurrence of acute kidney injury (AKI) in patients undergoing cardiac resynchronization therapy (CRT) implantation. The few studies that investigated the occurrence of AKI, reported an incidence of 8-14%. These studies focused entirely on the administration of contrast medium as etiological risk factor for AKI. However, CRT implantation requires substantially less administration of contrast medium, compared with other invasive procedures, such as percutaneous coronary intervention. Therefore, the high incidence of AKI post CRT implantation, suggests the existence of other patient or procedure-related factors that may contribute to AKI occurrence.</p> <p>Purpose: We aimed to assess the incidence of AKI post CRT and its impact on length of in-hospital stay (LOS), being the first to investigate the predictive value of patient and procedure-related risk factors for its occurrence.</p> <p>Methods: Retrospective observational study. Patients that underwent CRT implantation in our hospital between April 2014 and May 2019 were included. Univariate and multivariate logistic regression models were generated in order to identify independent predictors of AKI.</p> <p>Results: Twelve (20%) out of 60 patients developed AKI. Prior renal insufficiency predicted AKI significantly (p=0.033; OR: 10.1). Furthermore, larger procedure time, intraoperative hypotension and -bleeding, showed to be significant predictors (p=0.011; OR: 1.03, p=0.001; OR: 1.77, p=0.01; OR = 7.86, respectively). AKI was associated with a significantly longer LOS (p<0.01).</p> <p>Conclusions: AKI is a frequent complication of CRT implantation with an important impact on LOS. In addition to contrast administration, patient and procedure-related factors play a significant role in the occurrence of AKI. The physicians' awareness of this complication with its patient and procedure-related risk factors is crucial when considering patients for CRT.</p>
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