Association between postoperative ibuprofen exposure and acute kidney injury after pediatric cardiac surgery

Figures & data

Figure 1. Flow diagram of the cohort study.

Table 1. Characteristics of ibuprofen exposed vs unexposed. Data are number (percentage) or median (25th–75th percentiles).

Variable	Ibuprofen N = 396	No Ibuprofen N = 716	P Value
Age (months), median (IQR)	38.8 (13.6–71.5)	33.6 (9.7–66.6)	0.005
Male sex, N (%)	179 (54.8)	340 (52.5)	0.465
Weight (kg), median (IQR)	14.0 (9.0–20.0)	13.0 (8.0–19.1)	0.015
Previous cardiac surgeries, N (%)	37 (9.3)	23 (3.2)	<0.001
Preoperative cyanosis, N (%)	17 (4.3)	40 (5.6)	0.349
Emergent surgery, N (%)	1 (0.3)	5 (0.7)	0.331
RACHS-1 score, N /total N (%)			0.005
1	55 (13.9)	102 (14.3)
2	136 (34.3)	315 (44.0)
≥3	205 (51.8)	299 (41.7)
CPB time (min), median (IQR)	80 (53–114)	70 (47–104)	0.002
CPB time ≥120 min, N (%)	90 (22.7)	128 (17.9)	0.051
Cross-clamp time (min), median (IQR)	50 (29–76)	42 (25–67)	0.001
Baseline LVEF (%), median (IQR)	69 (65–73)	69 (65–72)	0.778
Baseline serum creatinine (mg/dL), median (IQR)	0.34 (0.27–0.43)	0.32 (0.24–0.40)	<0.001
Baseline serum albumin(g/L), median (IQR)	4.4 (4.2–4.5)	4.4 (4.1–4.5)	0.273
Baseline hemoglobin (g/dL), median (IQR)	12.4 (11.6–13.3)	12.3 (11.4–13.1)	0.011

IQR: interquartile range; RACHS: Risk Adjustment for Congenital Heart Surgery; CPB: cardiopulmonary bypass; LVEF: left ventricular ejection fraction.

Figure 2. The association between ibuprofen exposure and postoperative AKI. Three different methods were used to assess the association: (1) multivariable Cox regression with time-varying ibuprofen exposure, (2) the same multivariable Cox regression model with ibuprofen exposure defined as given ibuprofen within 48 h after surgery, (3) propensity score-matching analysis. PSM, propensity-score matching.

Figure 3. Subgroup and interaction analyses for age, RACHS-1 score, CPB time, and baseline serum creatinine. Multivariable Cox regression model with time-varying ibuprofen exposure was used to assess the association of ibuprofen exposure with AKI. RACHS, Risk Adjustment for Congenital Heart Surgery; CPB, cardiopulmonary bypass; HR, hazard ratio.

Table 2. Incidence of AKI according to ibuprofen exposure.

Outcome	Ibuprofen	No Ibuprofen	P Value
	N = 396	N = 716
Overall AKI	46 (11.6%)	152 (21.2%)	<0.001
Severe AKI	2 (0.5%)	36 (5.0%)	<0.001

AKI: acute kidney injury.

Data availability

The data of this study are available from the corresponding author, Jianhui Wang, upon reasonable request.