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논문분류	춘계학술대회 초록집
제목	Association Between Acute Kidney Injury And Early Mortality Following Cardiac Interventions: A Single-Center Cohort Study of 9,803 Patients
저자	Niloofar Deravi
출판정보	2026; 2026(1):
키워드	Acute Kidney Injury, Mortality, ICU stay, Cohort, Cardiac interventions
초록	Objectives: Acute kidney injury (AKI), a common complication after cardiac interventions, affects many patients and contributes to morbidity and mortality. Its pathophysiology includes ischemia-reperfusion injury, inflammation, oxidative stress, and nephrotoxic exposure. This cohort study investigated the association between AKI and short term mortality among patients undergoing cardiac interventions. Methods: This retrospective cohort study used the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 3.1) database. Adult patients who underwent cardiac interventions between 2008-2022 at Beth Israel Deaconess Medical Center were identified using International Classification of Diseases, Tenth Revision, Procedure Coding System codes. Those without pre or post procedure serum creatinine measurements or missing key baseline covariates were excluded. AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria (absolute increase ≥0.3 mg/dL within 48 hours or ≥1.5 times baseline within 7 days). The outcomes assessed were in-hospital, 30-day, and 90-day mortality and intensive care unit (ICU) length of stay. Multivariable logistic regression adjusted for demographic variables and comorbidities. Results: Among 9,803 patients, 3,302 (33.7%) developed AKI. Mortality was significantly higher in those with AKI compared with those without: 9.7% vs 1.5% in-hospital, 9.5% vs 2.3% at 30 days, and 17.1% vs 5.2% at 90 days (all P<0.001). ICU stay was longer in the AKI group (median 4.0 vs 2.0 days; P<0.001). At 90 days, adjusted odds of mortality were higher with AKI (odds ratio (OR) 2.78, 95% confidence interval (CI) 2.23–3.46) and with the percutaneous route (OR 7.08, 95% CI 5.53–9.06; both P<0.001). Within the AKI subgroup, mortality increased with higher KDIGO grade, showing a clear severity-dependent gradient. Conclusion: AKI occurred in one-third of patients. It also dependently associated with increased short-term mortality as well as prolonged ICU stay, and risk escalating by severity. Therefore, early risk stratification and preventive strategies are highly recommended to improve patient outcomes after cardiac interventions.
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