acute kidney injury risk factors for icu patients following cardiac surgery: the application of joint modeling

Authors

batoul khoundabi department of biostatistics, faculty of medical sciences, tarbiat modares university, tehran, ir iran

anoshirvan kazemnejad department of biostatistics, faculty of medical sciences, tarbiat modares university, tehran, ir iran; department of biostatistics, faculty of medical sciences, tarbiat modares university, tehran, ir iran. tel: +98-2182883875, fax: +98-2188006544

marjan mansourian department of epidemiology and biostatistics, school of public health , isfahan university of medical sciences, isfahan, ir iran

seyed mohammadreza hashemian critical care, chronic respiratory disease research center (crdrc), national research institute of tuberculosis and lung diseases (nritld), masih daneshvari hospital, shahid beheshti university of medical sciences, tehran, ir iran

abstract

conclusions where there is a relationship between two longitudinal and survival responses, joint modeling can estimate it. background admission to the icu (intensive care unit) is frequently complicated by early aki (acute kidney injury). the development of aki following cardiac surgery is particularly associated with increased mortality and morbidity. according to akin (acute kidney injury network) criteria, uo (urinary output) is a predictor for aki. objectives the goal of this study was to determine the effects of some aki risk factors on aki and also to investigate changes in uo as a predictor of aki using joint modeling. patients and methods in a retrospective study, 300 cardiac-operated patients, who had been admitted over a period of three years, were selected according to the consecutive sample selection method, using the icu at masih daneshvari hospital in iran as a referral center. the random mixed effect model and the survival model were used to investigate uo changes and estimate the effect of uo and other risk factors on the hazard rate of aki in a joint analysis. results aki occurred in 38.0% of patients. a significant decrease of uo occurred more often in female and infected patients, as well as those with a low dbp (diastolic blood pressure). the survival model showed that the risk of aki in females, older patients and patients with low dbp, lower uo and with infection was higher (p = 0.001). using joint modeling, the association parameter between the risk of aki and uo was estimated (-0.3, p = 0.002).

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Journal title:
trauma monthly

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