Hematologic Ratios in Postoperative Acute Kidney Injury

Children's Hospital Medical Center, Cincinnati

Overview

Acute kidney injury (AKI) is a common complication after surgery for congenital heart disease and is associated with significant morbidity and mortality. To-date, no biomarker has been universally implemented for predicting AKI in neonates after cardiac surgery. In this study, the use of hematological ratios will be evaluated for predicting AKI and postoperative outcomes in this patient cohort.

In adults, hematological ratios which can be calculated from a routinely ordered complete blood count with differential, such as the neutrophil/lymphocyte ratio, have been demonstrated to be correlated with acute kidney injury (AKI) and other clinical outcomes after cardiovascular surgery. In this retrospective observational study, the association between hematological ratios (neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, neutrophil/lymphocyte\*platelet ratio, monocyte/lymphocyte ratio, and plateletcrit) and postoperative AKI, morbidity (length of ICU stay, hospital stay, mechanical ventilation, vasoactive infusion-free days, etc.) and mortality will be evaluated in neonates who underwent cardiac surgery with cardiopulmonary bypass.

Study Type

OBSERVATIONAL

Conditions

Acute Kidney Injury

Interventions

Cardiac Surgery with Cardiopulmonary BypassPROCEDURE

Cardiac Surgery with Cardiopulmonary Bypass

Eligibility

Sex: ALLMin age: 0 DaysMax age: 31 Days

Medical Language ↔ Plain English

Inclusion Criteria: * Neonates (≤31 days) who underwent cardiac surgery with cardiopulmonary bypass for congenital heart disease. Exclusion Criteria: * Patients with missing relevant preoperative or postoperative data points * Patients with previous palliation or reoperation, * Thymus hypo/aplasia (DiGeorge Syndrome, Ataxia-telangiectasia, or Nezelof syndrome), * Primary immunodeficiency, * Episode of cardiac arrest within 1 week before surgery, * Signs or history of preoperative renal impairment or AKI (KDIGO Stage ≥1 observed on preoperative labs), * Hypothyroidism, * Patients with a history of infection within a week prior to surgery or antibiotics administered within the first 3 days after surgery (except for postoperative antibiotics).

Locations (1)

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Outcomes

Primary Outcomes

Acute Kidney Injury (AKI)

Occurrence of AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) diagnostic classification (using serum creatinine)

Time frame: up to 72 hours postoperative

Secondary Outcomes

Operative Mortality

Mortality within 30 days after surgery (rate)

Time frame: up to 30 days postoperative

1-year mortality

Mortality within 1 year after surgery (rate)

Time frame: up to 1 year postoperative

Length of hospital stay

Total length of hospital stay (days)

Time frame: up to 1 year postoperative

Length of Cardiac Intensive Care Unit (CICU) Stay

Total length of stay in the CICU (days)

Time frame: up to 1 year postoperative

Length of mechanical ventilation

Total length of postoperative mechanical ventilator support (days)

Time frame: up to 1 year postoperative

Vasoactive infusion-free days

(days)

Time frame: up to 28 days postoperative

Postoperative infection

Occurrence of infection defined as: antibiotic use (other than perioperative) within 3 days postop, positive blood culture within 3 days postop, positive viral panel within 3 days postop

Time frame: up to 3 days postoperative

Data from ClinicalTrials.gov

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