Incidence and circumstances of serum creatinine increase after abdominal aortic surgery.

OBJECTIVE

To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery.

DESIGN

Prospective clinical observational study.

SETTING

Surgical intensive care unit in a university hospital.

PATIENTS

Two hundred and fifteen consecutive adult patients operated on for infra-renal abdominal aortic surgery during 1 year.

INTERVENTIONS

A moderate increase in plasma creatinine of 20% from preoperative value (renal dysfunction, RD) was systematically recorded during the first 3 days following surgery. Organ dysfunctions (cardiac, pulmonary, haematological, and neurological) were assessed.

MEASUREMENTS AND RESULTS

Forty-three patients (20%) experienced a postoperative RD; six of these required dialysis. RD was associated with other organ dysfunctions in 60.5% patients. Mortality rate was significantly higher for patients who had a RD, than patients without RD (9.3% vs 1.2%, P<0.02). Mean ICU stay of patients with RD was significantly longer (7.9+/-5.6 days vs 5.0+/-1.8 days, P<0.01). However, patients with RD but without other organ dysfunctions had a mortality rate of 0% and did not have a significantly longer stay in ICU than patients without any organ dysfunctions (5.2+/-2.1 days vs 4.6+/-1.2 days, P=0.09).

CONCLUSION

Our results suggest that a postoperative 20%-increase in plasma creatinine after abdominal aortic surgery is not rare and occurs frequently with other organ dysfunction.