Time to peak bilirubin concentration and advanced AKI were associated with increased mortality in rheumatic heart valve replacement surgery patients with severe postoperative hyperbilirubinemia: a retrospective cohort study

Abstract Background Hyperbilirubinemia after heart valve surgery (HVS) with cardiopulmonary bypass is frequently observed and associated worse outcomes. We investigated the characteristics prognosis of patients severe hyperbilirubinemia HVS for rheumatic disease (RHD) to identify clinical outcomes potential risk factors. Methods Between 2015 2018, who underwent in cardiac intensive care unit our hospital were retrospectively screened. Risk factors acute kidney injury (AKI), requirement continuous renal replacement therapy (CRRT), in-hospital long-term mortality identified by univariate multivariate analyses. The patient survival proportion was graphically presented Kaplan–Meier method. Results A total 149 RHD had postoperative included. Of included patients, 80.5% developed AKI, 18.1% required CRRT. 30.2%. Backward logistic regression analysis showed that time peak TB concentration (odds ratio [OR] 1.557, 95% confidence interval [CI] 1.259–1.926; P < 0.001) advanced AKI (stage 2 3 AKI) (OR 19.408, CI 6.553–57.482; independent predictors mortality. cutoff value levels predicting 5 days. Conclusions Severe a life-threatening complication undergo RHD. Patients whose bilirubin continued increase past 5th day (stages 3) higher