Related Experiment Video

Updated: Jan 18, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.6K

New Insights in Assessing AKI 3 Risk Factors and Predictors Associated with On-Pump Surgical Aortic Valve Replacement

Anca Drăgan1, Adrian Ştefan Drăgan2

  • 1Department of Cardiovascular Anaesthesiology and Intensive Care, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, Romania.

Diagnostics (Basel, Switzerland)
|September 13, 2025
PubMed

Insights

Severe acute kidney injury (AKI) after cardiac surgery is linked to hemostasis reintervention, high vasoactive-inotropic score (VIS), and low lymphocyte counts. Prediction accuracy for AKI 3 varies significantly between male and female surgical aortic valve replacement patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Acute kidney injury (AKI) following cardiac surgery, particularly on-pump surgical aortic valve replacement (SAVR), poses significant risks including chronic kidney disease, increased costs, and mortality.
  • Identifying severe AKI (AKI 3) risk factors and predictive tools is crucial for improving patient outcomes and clinical management.
  • Sex differences in AKI prediction warrant further investigation to personalize risk stratification.

Purpose of the Study:

  • To identify independent risk factors for severe AKI (AKI 3) in patients undergoing on-pump SAVR.
  • To evaluate the predictive significance of inflammatory indexes and risk scores for AKI 3.
  • To analyze sex-specific differences in AKI 3 prediction.

Main Methods:

  • Retrospective analysis of 422 patients undergoing on-pump SAVR between 2022 and 2024.
  • Multivariable binary logistic regression to identify independent risk factors for AKI 3.
  • Analysis of inflammatory indexes (Systemic Inflammatory Response Index, Aggregate Index of Systemic Inflammation, Platelet-to-Lymphocyte Ratio) and risk scores (EuroSCORE, EuroSCORE II, Thakar score) for AKI 3 prediction, with a focus on sex differences.

Main Results:

  • 121 patients (28.67%) experienced AKI, with 27 (6.39%) classified as AKI 3.
  • Independent risk factors for AKI 3 included hemostasis reintervention (OR 9.76), early postoperative vasoactive-inotropic score (VIS) (OR 1.049), and postoperative lymphocyte count (OR 2.252).
  • Inflammatory indexes and delta PLR showed better prediction for AKI 3 in females compared to additive EuroSCORE but were less accurate than EuroSCORE II. Thakar score predicted AKI 3 exclusively in males.

Conclusions:

  • Early postoperative VIS, lymphocyte count, and hemostasis reintervention are independent risk factors for severe AKI in SAVR patients.
  • Significant sex-based differences exist in the prediction of AKI 3 using inflammatory markers and risk scores.
  • Personalized monitoring and risk stratification strategies may be necessary, considering patient sex.

Keywords:
acute kidney injurycardiac surgeryinflammatory indexesrisk factorssex differences

More Related Videos

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

12.2K
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

11.8K

Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
399
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
496
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
391
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
282
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
255
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
378