Correlation between stress-induced hyperglycemia and postoperative acute kidney injury in nondiabetic patients who underwent acute type A aortic dissection surgery: A retrospective observational study

BackgroundAcute type A aortic dissection is more common in acute and severe cases, and hyperglycemia on admission is associated with the risk of adverse outcomes in acute myocardial infarction. However, the impact of admission hyperglycemia on postoperative outcomes in patients who underwent acute type A aortic dissection surgery remains unclear.ObjectiveTo assess the prognostic value of admission hyperglycemia for postoperative outcomes, particularly the development of acute kidney injury, in nondiabetic patients undergoing acute type A aortic dissection surgery.MethodsThis retrospective study included 322 nondiabetic patients who underwent acute type A aortic dissection surgery at Wuhan Asian Heart Hospital between October 2018 and March 2021.ResultsThere was no significant difference in the incidence of postoperative death between the case and control groups. Sixty-nine patients developed postoperative acute kidney injury, and the incidence of postoperative acute kidney injury was significantly higher in the case group (29.2%) than in the control group (17.2%) (<i>p</i> = 0.012). Univariate analysis suggested statistically significant component differences in preoperative stress-induced hyperglycemia, systolic blood pressure, blood urea nitrogen, and intraoperative aortic cross-clamp time between the two groups. Further screening performed by including the above variables in a multifactorial analysis suggested that stress-induced hyperglycemia and systolic blood pressure might be independent risk factors for postoperative acute kidney injury.ConclusionThis study suggests a correlation between preoperative stress-induced hyperglycemia and the incidence of postoperative acute kidney injury in nondiabetic patients who underwent acute type A aortic dissection surgery.