CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 4, September/October 2023 200 AFRICA normalised co-operation and appropriate haemodynamic and respiratory function. Statistical analysis Statistical analysis was performed using the SPSS software version 22.0. Among the data measured, those showing normal distribution are expressed as mean ± standard deviation; those not showing a normal distribution are expressed as median (minimum–maximum). The data obtained by counting are given as percentages. Among the data measured, the difference between the groups was evaluated by the Student’s t-test in normal and homogenous distribution, and by the Mann–Whitney U-test in distribution that was not normal and homogenous. Among the data obtained by counting, the differences between the groups were evaluated by the parametric or non-parametric Pearson’s chi-squared test or Fisher’s exact test according to the distribution being parametric or not. The effects of the risk factors suggested to be influential on the early-period AKI were studied with univariate logistic regression analysis. The multiple effects of the risk factors that are effective or suggested to be effective in predicting early postoperative AKI, as a result of univariate statistical analysis, were studied with retrospective selective multivariate logistic regression analysis. The odds ratio, 95% confidence interval and significance level for each of the risk factors were found. The sensitivity and specificity of CIMT in predicting early postoperative AKI via receiver operating characteristic (ROC) curves were computed and results were found statistically significant for p < 0.05. Results The demographic characteristics and clinical data of the patients are summarised in Table 1. CIMTs were statistically significantly higher in group 1 patients (p = 0.0001). There were no statistically significant differences between the groups in terms of demographic and clinical properties. According to the KDIGO classification, 58.7% (n = 37) of the patients were stage I AKI, 36.5% (n = 23) were stage II and 4.8% (n = 3) were stage III. Renal failure requiring dialysis developed in two of three patients with stage III AKI. Pre-operative and early postoperative blood analysis and haematological parameters of the patients are summarised in Table 2. Pre-operative CRP (p = 0.0001), ESR (p = 0.0001), PLR (p = 0.0001) and NLR (p = 0.0001) were significantly different between the groups. Postoperative first-, third- and seventh-day CRP (p = 0.0001), postoperative first-, third- and seventh-day ESR (p = 0.0001), postoperative first-, third- and seventh-day PLR (p = 0.0001), and postoperative first-, third- and seventh-day NLR (p = 0.0001) were significantly different between the groups. Table 1. Comparison of patients’ characteristics between the two groups Patients’ characteristics Group I AKI (n = 63) Group II non-AKI (n = 174) p-value Age (years), median (min–max) 63 (42–74) 61.7 (32–74) 0.17** Male, n (%) 47 (74.6) 119 (68.4) 0.36* Female, n (%) 16 (25.4) 55 (31.6) BMI (kg/m2), median (min–max) 26.7 (20.5–33.7) 26.3 (18.3–37.1) 0.53** Hypertension, n (%) 21 (33.3) 57 (32.8) 0.93* Diabetes mellitus, n (%) 22 (34.9) 65 (37.4) 0.73* Smoking, n (%) 28 (44.4) 58 (33.302) 0.12* Hyperlipidaemia, n (%) 26 (41.3) 79 (45.4) 0.57* Ejection fraction (%), median (min–max) 55.8 (35–70) 55.6 (35-72) 0.87** Basal heart rate, median (min–max) 66.4 (55–85) 66.8 (54-85) 0.71* CIMT (mm), median (min–max) 0.72 (0.47–0.87) 0.56 (0.45-0.81) 0.0001** BMI: body mass index; CIMT: carotid intima–media thickness. *Pearson’s chi-squared test or Fisher’s exact test; **Mann–Whitney U-test. Table 2. Pre-operative and early postoperative blood results and haematological parameters of patients Haematological parameters Group I AKI (n = 63) Group II non-AKI (n = 174) p-value Median (min–max) Median (min–max) Creatinine (mg/dl) Pre-operative 0.68 (0.42–1.42) 0.65 (0.37–1.41) 0.56* Urea (mg/dl) Pre-operative 21.9 (12–39) 22.1 (14–39) 0.93* eGFR (ml/min/1.73 m2) Pre-operative 99.0 (60–147) 98.8 (55–158) 0.71* HbA1c (%) Pre-operative 5.8 (4.5–9.8) 5.7 (4.3–11.2) 0.18* LDL-C (mg/dl) Pre-operative 118.6 (89–156) 119.0 (88–165) 0.59* Haemoglobin (mg/dl) Pre-operative 13.3 (10.5–17.1) 13.7 (10.1–16.5) 0.36* Postoperative day 1 8.8 (7.4–12.0) 8.9 (7.4–12.9) 0.68* Haematocrit (%) Pre-operative 39.2 (30.5–48.9) 40.8 (30.6–48.9) 0.60* Postoperative day 1 27.7 (24.3–35.8) 28.2 (23.8–38.4) 0.77* Uric acid (mg/dl) Pre-operative 6.0 (2.3–9.7) 5.7 (2.2–9.1) 0.12* Postoperative day 1 5.7 (4.5–9.8) 5.8 (4.3–10.8) 0.78* Leukocyte count (× 103 cells/µl) Pre-operative 8.1 (5.0–10.9) 7.9 (4.1–10.9) 0.61* Postoperative day 1 13.6 (5.8–22.4) 12.8 (6.1–30.4) 0.16* Postoperative day 3 11.6 (5.1–26.4) 11.2 (4.6–25.7) 0.24* Postoperative day 7 10.1 (5.2–24.6) 9.7 (4.3–25.1) 0.06* CRP (mg/l) Pre-operative 1.79 (0.17–4.51) 0.51 (0.16–2.51) 0.0001* Postoperative day 1 32.5 (20.3–51.2) 27.4 (18.4–39.2) 0.0001* Postoperative day 3 45.7 (23.4–74.2) 28.1 (18.3–51.7) 0.0001* Postoperative day 7 19.4 (7.9–47.8) 9.5 (1.1–39.2) 0.0001* ESR (mm/h) Pre-operative 13.2 (2–19) 8.1 (2–19) 0.0001* Postoperative day 1 42.3 (13–61) 30.2 (10–74) 0.0001* Postoperative day 3 60.5 (32–88) 40.4 (23–81) 0.0001* Postoperative day 7 37.8 (18–51) 26.6 (16–50) 0.0001* PLR Pre-operative 152.7 (119.2–163.8) 135.2 (98.7–156.5) 0.0001* Postoperative day 1 158.7 (103.6–198.6) 128.8 (85.8–187.8) 0.0001* Postoperative day 3 152.8 (107.6–194.4) 124.4 (86.4–181.3) 0.0001* Postoperative day 7 145.7 (95.4–185.8) 124.8 (68.7–196.9) 0.0001* NLR Pre-operative 5.2 (2.3–6.2) 3.5 (1.5–5.9) 0.0001* Postoperative day 1 6.6 (3.9–9.7) 5.1 (2.1–8.4) 0.0001* Postoperative day 3 6.1 (2.9–9.7) 4.9 (1.7–9.5) 0.0001* Postoperative day 7 5.2 (2.1–8.6) 3.8 (1.3–7.9) 0.0001* CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; PLR: plateletto-lymphocyte ratio; NLR: neutrophil-to-lymphocyte ratio; eGFR: estimated glomerular filtration rate; HbA1c: glycosylated haemoglobin; LDL-C: low-density lipoprotein cholesterol. *Mann–Whitney U-test.
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