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Structural equation modelling exploration of the key pathophysiological processes involved in cardiac surgery-related acute kidney injury in infants

Overview of attention for article published in Critical Care, June 2016
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  • Good Attention Score compared to outputs of the same age (70th percentile)

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Title
Structural equation modelling exploration of the key pathophysiological processes involved in cardiac surgery-related acute kidney injury in infants
Published in
Critical Care, June 2016
DOI 10.1186/s13054-016-1350-1
Pubmed ID
Authors

Mirela Bojan, Maria Constanza Basto Duarte, Natalia Ermak, Vanessa Lopez-Lopez, Agnès Mogenet, Marc Froissart

Abstract

Uncertainties about the pathophysiological processes resulting in cardiac surgery-related acute kidney injury (AKI) in infants concern the relative impact of the most prominent risk factors, the clinical relevance of changes in glomerular filtration rate vs tubular injury, and the usefulness of available diagnostic tools. Structural equation modelling could allow for the assessment of these complex relationships. A structural model was specified using data from a prospective observational cohort of 200 patients <1 year of age undergoing cardiopulmonary bypass surgery. It included four latent variables: AKI, modelled as a construct of perioperative creatinine variation, of oliguria and of urine neutrophil gelatinase-associated lipocalin (uNGAL) concentrations; the cardiopulmonary bypass characteristics; the occurrence of a post-operative low cardiac output syndrome and the post-operative outcome. The model showed a good fit, and all path coefficients were statistically significant. The bypass was the most prominent risk factor, with a path coefficient of 0.820 (95 % CI 0.527-0.979), translating to a 67.2 % explanation for the risk of AKI. A strong relationships was found between AKI and early uNGAL excretion, and between AKI and the post-operative outcome, with path coefficients of 0.611 (95 % CI 0.347-0.777) and 0.741 (95 % CI 0.610-0.988), respectively. The path coefficient between AKI and a >50 % increase in serum creatinine was smaller, with a path coefficient of 0.443 (95 % CI 0.273-0.596), and was intermediate for oliguria, defined as urine output <0.5 ml kg(-1) h(-1), with a path coefficient of 0.495 (95 % CI 0.250-0.864). A path coefficient of -0.229 (95 % CI -0.319 to 0.060) suggested that the risk of AKI during the first year of life did not increase with younger age at surgery. These findings suggest that cardiac surgery-related AKI in infants is a translation of tubular injury, predominately driven by the cardiopulmonary bypass, and linked to early uNGAL excretion and to post-operative outcome. ClinicalTrials.gov identifier NCT01219998 . Registered 11 October 2010.

X Demographics

X Demographics

The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Italy 1 2%
Unknown 41 98%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 5 12%
Student > Bachelor 5 12%
Other 4 10%
Lecturer 3 7%
Student > Ph. D. Student 3 7%
Other 13 31%
Unknown 9 21%
Readers by discipline Count As %
Medicine and Dentistry 18 43%
Nursing and Health Professions 5 12%
Psychology 3 7%
Pharmacology, Toxicology and Pharmaceutical Science 2 5%
Earth and Planetary Sciences 2 5%
Other 2 5%
Unknown 10 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 November 2017.
All research outputs
#6,847,541
of 25,374,647 outputs
Outputs from Critical Care
#3,836
of 6,554 outputs
Outputs of similar age
#102,898
of 354,780 outputs
Outputs of similar age from Critical Care
#96
of 111 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 354,780 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 111 others from the same source and published within six weeks on either side of this one. This one is in the 13th percentile – i.e., 13% of its contemporaries scored the same or lower than it.