Association between Creatinine Trajectories and All-Cause Mortality in Elderly Patients after Cardiac Surgery: A

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Published on: August 9, 2013

Yujie Fan1, Zefeng Yang1, Jiayao Wei1

  • 1Department of Cardiothoracic Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China.

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|April 5, 2026
PubMed

Insights

Monitoring serum creatinine trajectories after cardiac surgery offers prognostic value. A persistently increasing creatinine level independently predicts higher mortality risk in elderly patients compared to a stable trend.

Area of Science:

  • Nephrology
  • Cardiology
  • Geriatric Medicine

Background:

  • Conventional serum creatinine monitoring at single time points inadequately reflects disease progression.
  • Predicting postoperative outcomes in elderly cardiac surgery patients requires improved prognostic markers.

Purpose of the Study:

  • To evaluate the prognostic significance of distinct serum creatinine trajectories.
  • To assess the association of these trajectories with all-cause mortality in elderly cardiac surgery patients.

Main Methods:

  • Retrospective cohort study utilizing the MIMIC-IV database.
  • Identification of three serum creatinine trajectories: low-stable, persistent-increase, and transient-increase.
  • Kaplan-Meier analysis and multivariable Cox proportional hazards models for survival outcomes.

Main Results:

  • Analysis included 5145 elderly patients undergoing cardiac surgery.
  • The persistent-increase trajectory (Class 2) showed the highest in-hospital and 1-year mortality.
  • The transient-increase trajectory (Class 3) also had higher mortality than the low-stable trajectory (Class 1).

Conclusions:

  • Distinct serum creatinine trajectory patterns provide independent prognostic information.
  • A persistently increasing creatinine trajectory is significantly associated with increased mortality post-cardiac surgery.
  • Trajectory analysis enhances prediction of postoperative outcomes in elderly cardiac surgery patients.
Abstract

Keywords:
cardiac surgerycreatininemortalitytrajectory analysis

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