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Table 6 Associations of preoperative factors with any-stage acute kidney injury (AKI) in the development sample (Bristol and Birmingham)

From: Predictive models for kidney disease: improving global outcomes (KDIGO) defined acute kidney injury in UK cardiac surgery

 

Number

Number (%)

Unadjusted

Fully adjusted

 

Total

Any AKI

Odds ratio

95% CI

P -value

Odds ratio

95% CI

P -value

Demographic factors

        

Age, years

        

 <60

4,056

485 (12.0)

1.00

  

1.00

  

 60 to 74

9,074

2,039 (22.5)

2.13

(1.92, 2.37)

 

1.53

(1.35, 1.74)

 

 ≥75

3,397

1,270 (37.4)

4.40

(3.91, 4.94)

<0.001

2.21

(1.91, 2.57)

<0.001

Sex

        

 Male

12,464

2,891 (23.2)

1.00

  

1.00

  

 Female

4,063

903 (22.2)

0.95

(0.87, 1.03)

0.202

0.53

(0.48, 0.59)

<0.001

Body mass index

        

 <20.0

594

175 (29.5)

1.60

(1.33, 1.92)

 

0.80

(0.64, 0.99)

 

 20.0 to 24.9

4,209

931 (22.1)

1.08

(0.99, 1.19)

 

0.79

(0.71, 0.88)

 

 25.0 to -29.9

7,422

1,540 (20.7)

1.00

  

1.00

  

 30.0 to 34.9

3,258

854 (26.2)

1.36

(1.23, 1.49)

 

1.75

(1.57, 1.95)

 

 35.0+

1,044

294 (28.2)

1.50

(1.29, 1.73)

<0.001

2.11

(1.78, 2.50)

<0.001

Smoking status

        

 Never smoked

5,321

1,122 (21.1)

1.00

  

1.00

  

 Ex-smoker

9,499

2,315 (24.4)

1.21

(1.11, 1.31)

 

1.09

(1.00, 1.20)

 

 Current smoker

1,707

357 (20.9)

0.99

(0.87, 1.13)

<0.001

1.41

(1.22, 1.64)

<0.001

Preoperative factors

        

Angina

        

 No angina

3,083

810 (26.3)

1.00

  

1.00

  

 CCS 1

1,859

409 (22.0)

0.79

(0.69, 0.91)

 

0.84

(0.73, 0.98)

 

 CCS 2

4,965

994 (20.0)

0.70

(0.63, 0.78)

 

0.79

(0.69, 0.90)

 

 CCS 3

3,834

870 (22.7)

0.82

(0.74, 0.92)

 

0.80

(0.70, 0.92)

 

 CCS 4

2,786

711 (25.5)

0.96

(0.86, 1.08)

<0.001

0.75

(0.64, 0.87)

0.002

Dyspnoea

        

 NYHA 1

3,583

610 (17.0)

1.00

  

1.00

  

 NHYA 2

7,223

1,465 (20.3)

1.24

(1.12, 1.38)

 

1.07

(0.95, 1.19)

 

 NYHA 3

4,823

1,360 (28.2)

1.91

(1.72, 2.13)

 

1.29

(1.14, 1.46)

 

 NYHA 4

898

359 (40.0)

3.25

(2.77, 3.81)

<0.001

1.37

(1.13, 1.66)

<0.001

Previous MI

        

 0

10,457

2,272 (21.7)

1.00

  

1.00

  

 1

4,928

1,174 (23.8)

1.13

(1.04, 1.22)

 

0.99

(0.90, 1.10)

 

 ≥2

1,142

348 (30.5)

1.58

(1.38, 1.81)

<0.001

1.04

(0.88, 1.21)

0.879

Previous operations

        

 0

15,835

3,578 (22.6)

1.00

  

1.00

  

 1+

692

216 (31.2)

1.55

(1.32, 1.83)

<0.001

1.39

(1.15, 1.67)

0.007

Preoperative diabetes

        

 No

13,419

2,824 (21.0)

1.00

  

1.00

  

 Yes

3,108

970 (31.2)

1.70

(1.56, 1.86)

<0.001

1.41

(1.28, 1.55)

<0.001

Peripheral vascular disease

        

 No

14,924

3,237 (21.7)

1.00

  

1.00

  

 Yes

1,603

557 (34.7)

1.92

(1.72, 2.15)

<0.001

1.31

(1.16, 1.48)

<0.001

Pulmonary disease

        

 No

14,490

3,217 (22.2)

1.00

  

1.00

  

 Yes

2,037

577 (28.3)

1.38

(1.25, 1.54)

<0.001

1.07

(0.96, 1.20)

0.240

Neurological disease

        

 No

15,093

3,346 (22.2)

1.00

  

1.00

  

 Yes

1,434

448 (31.2)

1.60

(1.42, 1.80)

<0.001

1.14

(1.00, 1.30)

0.044

Hypertension

        

 No

5,707

1,028 (18.0)

1.00

  

1.00

  

 Yes

10,820

2,766 (25.6)

1.56

(1.44, 1.69)

<0.001

1.28

(1.17, 1.40)

<0.001

Haemoglobin

        

 <10.0

309

133 (43.0)

2.98

(2.37, 3.74)

 

1.58

(1.23, 2.04)

 

 10.0 to11.9

2,080

800 (38.5)

2.46

(2.23, 2.72)

 

1.67

(1.49, 1.87)

 

 12.0+

14,138

2,861 (20.2)

1.00

 

<0.001

1.00

 

<0.001

Glomerular filtration rate

        

 <30.0

538

283 (52.6)

5.64

(4.71, 6.75)

 

4.64

(3.73, 5.77)

 

 30.0 to 59.9

6,052

1,917 (31.7)

2.36

(2.17, 2.56)

 

2.25

(2.03, 2.48)

 

 60.0 to 89.9

7,199

1,184 (16.4)

1.00

  

1.00

  

 90.0+

2,738

410 (15.0)

0.89

(0.79, 1.01)

<0.001

0.82

(0.71, 0.95)

<0.001

Heparin or nitrates

        

 None

14,319

3,086 (21.6)

1.00

  

1.00

  

 Within a week

967

299 (30.9)

1.63

(1.41, 1.88)

 

1.31

(1.11, 1.55)

 

 At operation

1,241

409 (33.0)

1.79

(1.58, 2.03)

<0.001

1.27

(1.08, 1.48)

0.001

Critical preoperative event

        

 No

16,212

3,640 (22.5)

1.00

     

 Yes

315

154 (48.9)

3.30

(2.64, 4.13)

<0.001

1.57

(1.19, 2.06)

0.002

Catheter to surgery

        

 Within 24 h

337

125 (37.1)

1.95

(1.55, 2.44)

 

1.17

(0.87, 1.57)

 

 >24 h this admission

7,844

1,730 (22.1)

0.93

(0.87, 1.01)

 

0.80

(0.72, 0.88)

 

 >24 h prev admission

8,346

1,939 (23.2)

1.00

 

<0.001

1.00

 

<0.001

Triple vessel disease

        

 No

7,800

1,697 (21.8)

1.00

  

1.00

  

 Yes

8,727

2,097 (24.0)

1.14

(1.06, 1.22)

<0.001

1.24

(1.12, 1.37)

<0.001

Left main stem disease

        

 No

13,370

3,014 (22.5)

1.00

     

 Yes

3,157

780 (24.7)

1.13

(1.03, 1.23)

<0.001

1.00

(0.90, 1.11)

0.986

Ejection fraction

        

 Good (50+ %)

11,869

2,362 (19.9)

1.00

  

1.00

  

 Fair (30 to 49%)

3,811

1,121 (29.4)

1.68

(1.54, 1.82)

 

1.22

(1.11, 1.34)

 

 Poor (<30%)

847

311 (36.7)

2.34

(2.02, 2.70)

<0.001

1.34

(1.13, 1.59)

<0.001

Operative priority

        

 Elective

10,148

2,043 (20.1)

1.00

  

1.00

  

 Urgent

6,152

1,644 (26.7)

1.45

(1.34, 1.56)

 

1.33

(1.20, 1.48)

 

 Emergency/Salvage

227

107 (47.1)

3.54

(2.71, 4.61)

<0.001

1.93

(1.34, 2.76)

<0.001

Cardiac procedures

        

 CABG only

10,828

2,167 (20.0)

1.00

  

1.00

  

 Valve only

2,482

553 (22.3)

1.15

(1.03, 1.27)

 

1.27

(1.08, 1.48)

 

 CABG+valve

1,723

644 (37.4)

2.39

(2.14, 2.66)

 

1.81

(1.59, 2.07)

 

 Other/multiple

1,494

430 (28.8)

1.62

(1.43, 1.82)

<0.001

1.62

(1.39, 1.89)

<0.001

  1. CCS, Canadian Cardiovascular Society; NYHA, New York Heart Association; MI, myocardial infarction; prev, previous; CABG, coronary artery bypass graft; Haemoglobin, g/dL; GFR, mL/min.
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