The Impact of Acute Kidney Injury in the Perioperative Period on the Incidence of Postoperative Delirium in Patients Undergoing Coronary Artery Bypass Grafting—Observational Cohort Study

Katarzyna Kotfis, Justyna Ślozowska, Mariusz Listewnik, Aleksandra Szylińska and Iwona Rotter
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Katarzyna Kotfis: Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
Justyna Ślozowska: Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
Mariusz Listewnik: Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
Aleksandra Szylińska: Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland
Iwona Rotter: Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland

IJERPH, 2020, vol. 17, issue 4, 1-11

Abstract: Recent data indicate that acute kidney damage leads to inflammation in the brain and other distant organs. The purpose of this study was to investigate the effect of acute kidney injury (AKI) according to the Kidney Disease Improving Global Outcome (KDIGO) criteria on the occurrence of postoperative delirium in patients undergoing coronary artery bypass grafting (CABG). We performed a retrospective cohort analysis that included all consecutive patients undergoing elective CABG. The CAM-ICU (Confusion Assessment Method for Intensive Care Unit) was used for delirium assessment. Patients were divided into four groups, depending on the occurrence of AKI in the perioperative period according to KDIGO criteria. Overall, 902 patients were included in the final analysis, the mean age was 65.95 ± 8.01 years, and 76.83% were males (693/957). The majority of patients presented with normal kidney function-baseline creatinine level of 0.91 ± 0.21 (mg/dL). The incidence of AKI in the perioperative setting was 22.17% (200/902). Postoperative delirium was diagnosed in 115/902 patients (12.75%). Compared with no AKI, the odds of developing POD were increased for KDIGO stage 1 (OR 2.401 (95% confidence interval 1.484–3.884), p < 0.001); KDIGO stage 2 (OR 3.387 (95% confidence interval 1.459–7.866), p = 0.005); and highest for KDIGO stage 3 (OR equal to 9.729 (95% confidence interval 2.675–35.382), p = 0.001). Acute kidney injury, based on AKI staging, should be regarded as an independent risk factor for postoperative delirium after cardiac surgery.

Keywords: acute kidney injury; AKI; KDIGO; POD; delirium; creatinine; glomerular filtration rate; GFR; CABG (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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