Incidence, risk factors, and prognosis of a moderate increase in plasma XXXX early after cardiac surgery.

@entity1 @entity8 @entity881 @entity299 @entity1011 @entity204
OBJECTIVE: To evaluate the incidence and prognosis of a moderate increase in serum @entity1011 early after cardiac surgery. DESIGN: Retrospective clinical study. SETTING: Surgical intensive care unit in a university hospital. @entity1 : Five hundred and ninety-one consecutive adult @entity1 operated on for cardiac surgery during 1 year. INTERVENTIONS: Plasma @entity1011 was measured systematically before and during the first 3 days after surgery. Comorbid events were assessed as @entity881 (cardiac, pulmonary, hematologic, and neurologic), allowing us to calculate for each @entity1 a dysfunction score (0-5). MEASUREMENTS AND MAIN RESULTS: Postoperative plasma @entity1011 increased by > or =20% in 15.6% of @entity1 ; eight of these required dialysis. A 20% increase in plasma @entity1011 was associated with other @entity881 in 79.3% of @entity1 . Overall mortality rate was 2.7% and increased with the dysfunction score (17.7% for a dysfunction score > or =3). Mortality rate was 12.0% for @entity1 who had 20% increased plasma @entity1011 with other @entity881 but was 0% for @entity1 without other @entity881 . A logistic regression analysis revealed that the most important prognostic factors of @entity204 were @entity299 (odds ratio, 8.5; 95% confidence interval, 2.2-32.5) and the association of @entity8 (odds ratio = 12.0; 95% confidence interval, 3.9-37.2). Mean intensive care unit stay of @entity1 with increased plasma @entity1011 was significantly longer (8.1 +/- 5.6 vs. 4.3 +/- 1.4 days, p <.01) and increased significantly with the dysfunction score (p <.01). @entity1 with isolated increased plasma @entity1011 had a significantly longer stay in the intensive care unit than @entity1 without any @entity881 (4.6 +/- 1.4 vs. 3.9 +/- 0.9, p <.01). CONCLUSION: Our results suggest that a postoperative 20% increase in plasma @entity1011 after cardiac surgery is not rare and has a significant impact on postoperative outcome, mainly when multiple @entity881 occurs. Any preoperative reduced renal reserve or perioperative @entity8 increases the renal risk.
