{
    "abstract": "Severe acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality.\nIn this retrospective propensity score-matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72\u00a0hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS).\nStage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P\u00a0<\u00a0.001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71-3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45).\nStage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity.",
    "authors": [
        {
            "affiliation": "Division of Nephrology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo.",
            "firstname": "Benjamin R",
            "initials": "BR",
            "lastname": "Griffin"
        },
        {
            "affiliation": "Division of Critical Care, Department of Medicine, Washington University, St Louis, Mo.",
            "firstname": "J Pedro",
            "initials": "JP",
            "lastname": "Teixeira"
        },
        {
            "affiliation": "Division of Nephrology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo.",
            "firstname": "Sophia",
            "initials": "S",
            "lastname": "Ambruso"
        },
        {
            "affiliation": "Adult and Child Consortium for Health Outcomes Research and Delivery Science and Surgical Outcomes and Applied Research, University of Colorado, Aurora, Colo.",
            "firstname": "Michael",
            "initials": "M",
            "lastname": "Bronsert"
        },
        {
            "affiliation": "Division of Cardiothoracic Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, Colo; Rocky Mountain Regional VA Medical Center, Aurora, Colo.",
            "firstname": "Jay D",
            "initials": "JD",
            "lastname": "Pal"
        },
        {
            "affiliation": "Division of Cardiothoracic Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, Colo; Rocky Mountain Regional VA Medical Center, Aurora, Colo.",
            "firstname": "Joseph C",
            "initials": "JC",
            "lastname": "Cleveland"
        },
        {
            "affiliation": "Division of Cardiothoracic Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, Colo; Rocky Mountain Regional VA Medical Center, Aurora, Colo.",
            "firstname": "T Brett",
            "initials": "TB",
            "lastname": "Reece"
        },
        {
            "affiliation": "Division of Cardiothoracic Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, Colo; Rocky Mountain Regional VA Medical Center, Aurora, Colo.",
            "firstname": "David A",
            "initials": "DA",
            "lastname": "Fullerton"
        },
        {
            "affiliation": "Division of Nephrology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo; Rocky Mountain Regional VA Medical Center, Aurora, Colo.",
            "firstname": "Sarah",
            "initials": "S",
            "lastname": "Faubel"
        },
        {
            "affiliation": "Division of Cardiothoracic Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, Colo; Rocky Mountain Regional VA Medical Center, Aurora, Colo. Electronic address: muhammad.aftab@cuanschutz.edu.",
            "firstname": "Muhammad",
            "initials": "M",
            "lastname": "Aftab"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jtcvs.2019.11.004",
    "journal": "The Journal of thoracic and cardiovascular surgery",
    "keywords": [
        "acute kidney injury",
        "cardiac surgery",
        "cardiopulmonary bypass",
        "postoperative complications",
        "postoperative infection",
        "propensity-score matching"
    ],
    "methods": null,
    "publication_date": "2020-02-03",
    "pubmed_id": "32007252\n28434550\n26559305\n26141328\n23394211\n27716701\n9576407\n15153571\n24826910\n29940876\n23133643\n17699448\n21921612\n27113694\n16159846\n28341473\n26321440\n27261082\n29508077\n12787415\n8196394\n24123228\n19757444\n25276301\n2586128\n28941537\n23427891\n17568330\n18048039\n12717692\n21933399\n25993322\n30449575\n28110412\n30195592",
    "results": "Stage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P\u00a0<\u00a0.001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71-3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45).",
    "title": "Stage 1 acute kidney injury is independently associated with infection following cardiac surgery.",
    "xml": "<Element 'PubmedArticle' at 0x788503344d60>"
}