• Wenbin Meng, Rui Li, Lihua E, and Nashunbayaer Zha.
• Department of Obstetrics and Gynecology.
• Medicine (Baltimore). 2021 Jan 15; 100 (2): e23426e23426.

ObjectiveTo evaluate the impact of postoperative acute kidney injury (AKI) on early and long-term mortality in patients with acute aortic dissection by conducting a meta-analysis.MethodsAn extensive literature search was performed in PubMed and Embase databases until February 15, 2020. Observational studies that reported the associations between postoperative AKI and early (in-hospital and within 30 days) or long-term mortality in patients with acute aortic dissection were included.ResultsSeven studies comprising 1525 acute aortic dissection patients were identified. A random effect meta-analysis showed that postoperative AKI was significantly associated with higher risk of long-term mortality (risk ratio [RR] 2.32; 95% confidence interval [CI] 1.50-3.59). Subgroup analysis revealed that the pooled RR of long-term mortality was 1.42 (95% CI 0.90-2.22) for stage 1 AKI, 1.72 (95% CI 0.95-3.12) for stage 2 AKI, and 4.46 (95% CI 2.72-7.32) for stage 3 AKI, respectively. Furthermore, postoperative stage 3 AKI was associated with an increased risk of early mortality (RR 11.3; 95% CI 4.2-30.5).ConclusionsThis meta-analysis provided clinical evidence that postoperative stage 3 AKI is associated with higher risk of early and long-term mortality, even after adjusting important confounding factors. However, the current findings should be interpreted with caution due to the retrospective nature and limited number of studies analyzed.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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