Influencing Factors and Predictive Model of Acute Kidney Injury After Off-Pump Coronary Artery Bypass Grafting

CHEN Haiquan; SHAO Songhai; WANG Heng

doi:10.3969/j.issn.1004-437X.2026.06.019

Abstract：Objective To analyze the influencing factors of acute kidney injury(AKI)after off-pump coronary artery bypass grafting(OPCAB),and to establish and validate the risk prediction model.Methods Clinical data of 357 OPCAB patients admitted to the Second People's Hospital of Pingdingshan from June 2021 to January 2024 were retrospectively analyzed and randomly divided into a training set(286 cases)and a validation set(71 cases)at 8∶2.According to whether AKI occurred 48 hours after OPCAB operation,the patients were divided into non-occurrence group and occurrence group.The influencing factors of AKI after OPCAB operation were analyzed,and the risk prediction model of AKI after OPCAB operation was constructed and verified.Results Among 286 patients in the training set,the incidence of AKI within 48 hours after surgery was 25.87％(74/286).In the validation set of 71 patients,the incidence rate within 48 hours after surgery was 28.17％(20/71).The levels of hypertension,the proportion of patients aged ≥ 65 years and neutrophil-to-lymphocyte ratio(NLR)in the training set development group were higher than non-development group(P＜0.05),and the levels of albumin(ALB)and hemoglobin-to-red blood cell distribution width ratio(HRR)in the training set development group were lower than those in the non-development group(P＜0.05).Logistic regression analysis showed that hypertension,age,ALB,HRR and NLR were all factors influencing AKI after OPCAB operation(P＜0.05).The sensitivity,specificity and area under the curve were 87.84％(95％CI:75.37％-91.83％),90.57％(95％CI:79.23％-95.62％),and 0.905(95％CI:0.821-0.964)for predicting AKI after OPCAB.The sensitivity,specificity and area under the curve were 85.00％(95％CI:72.46％-90.05％),88.24％(95％CI:75.42％-93.18％),and 0.898(95％CI:0.815-0.956).Conclusion Hypertension,age,ALB,HRR and NLR are associated with the risk of AKI after OPCAB,and a risk prediction model can be established to assess the risk of AKI early.