| Summary: | In line with advances in surgery, perioperative care, and intensive care, the outcome in patients treated for cardiovascular disease has improved. Open-heart surgery is common in most western countries and, in line with the general ageing of populations, the frequency of these procedures is expected to increase in the coming decades. Patients who undergo cardiac surgery often have complex medical problems that predispose them to a range of surgical complications. Among the most common postoperative complications are arrhythmias, most often atrial fibrillation, and bleeding. Acute kidney injury (AKI) is also a common and often serious complication―as well as being a strong risk factor for worse postoperative outcome and increased mortality after surgery. However, many previous studies have suffered from a lack of data on baseline kidney function before AKI as well as selective patient cohorts. Approximately 250 open-heart surgeries are performed annually in Iceland. However, there has been a lack of data on the incidence and risk factors for AKI following heart surgery. The aim of the studies in this thesis was to evaluate the incidence of AKI using internationally validated criteria. Furthermore, we wanted to examine the association between AKI and other postoperative complications, and also long-term outcome, mainly regarding kidney function and survival. In that context, we particularly examined the effect of recovery of renal function on long-term outcome. Data were gathered from comprehensive nationwide databases that contained detailed information on all patients who underwent heart surgery in Iceland from 2001 through 2015. Information on kidney function, both pre- and postoperatively, was recorded in a thorough manner, as it is a prerequisite for reliable evaluation of AKI. The studies showed that the incidence of AKI after cardiac surgery in Iceland was relatively low compared to neighboring countries. In line with previous studies, the preoperative condition of patients was shown to be associated with ...
|
|---|