Correlation Analysis Of Urinary Occult Blood Intensity Immediately After Surgery, Acute Kidney Injury Related To Cardiac Surgery And Adverse Results During Hospitalization

[Objective]To evaluate the predictive value of instant postoperative strong positive microscopic hematuria on the incidence of cardiac surgery associated acute kidney injury(CSA-AKI)and other adverse outcomes during hospitalization.[Methods]A total of 1,371 patients undergoing cardiac surgery from Sep.2011 to Nov.2013 in Fuwai hospital were prospectively enrolled in this study,and retrospectively analyzed.Of these,298 patients were with strong positive microscopic hematuria(>?+++,Uric dry-chemistry method)and 1,073 with negative result.Propensity score matching(PSM)was employed to balance the variance of the baseline variables between the two groups.Outcome measures include the incidence of AKI,serious AKI,the duration of mechanical ventilation,ICU stay,hospital stay and in-hospital main adverse cardiovascular and cerebrovascular events(MACCE).[Results]PSM with 1:1 matching yielded 212 patients in each group.Compared with those with negative result,patients with strong positive instant postoperative microscopic hematuria were more likely to have higher incidence of AKI(53.8%vs.42.0%in standard of AKIN;35.4%vs.25.0%in standard of RIFLE criterion,both P<0.05)and serious AKI(9%vs 2.8%,P<0.05),longer duration of mechanical ventilation(median 17 vs.16 hours),longer ICU stay(median 43 vs.30 days)and hospital stay(median 7 vs.7 days,all P<0.05).However,there was no significant difference in incidence of in-hospital MACCE between two groups(8.5%vs 3.3%,P =0.057).[Conclusions]Strong positive instant postoperative microscopic hematuria was associated higher incidence of surgery related AKI and serious AKI,and worse in-hospital adverse outcomes.It may serve as a risk factor for preliminary risk stratification in postoperative patients when present in ICU.