分析骨科患者的肾功能障碍。
Analysis of kidney dysfunction in orthopaedic patients.
机构信息
Department of Trauma and Orthopaedics, General Hospital of Levadia, Levadia, Greece.
出版信息
BMC Nephrol. 2012 Sep 3;13:101. doi: 10.1186/1471-2369-13-101.
BACKGROUND
This retrospective study was undertaken to determine the incidence of kidney dysfunction (KD) and to identify potential risk factors contributing to development of KD in orthopaedic population following an elective or emergency surgery.
METHODS
A total of 1025 patients were admitted in our institution over a period of one year with various indications. Eight hundred and ninety-three patients (87.1%) had a surgical procedure. There were 42 (52.5%) male and 38 (47.5%) female with a mean age of 72 years (range: 47 to 87 years). We evaluated the following potential risk factors: age, comorbidities, shock, hypotension, heart failure, medications (antibiotics, NSAIDs, opiates), rhabdomyolysis, imaging contrast agents and pre-existing KD.
RESULTS
The overall incidence of KD was 8.9%. Sixty-eight patients developed acute renal injury (AKI) and 12 patients developed acute on chronic kidney disease (CKD). In sixty-six (82.5%) patients renal function was reversed to initial preoperative status. Perioperative dehydration (p = 0.002), history of diabetes mellitus (p = 0.003), pre-existing KD (p = 0.004), perioperative shock (p = 0.021) and administration of non-steroid anti-inflammatory drugs (NSAIDs) (p = 0.028) or nephrotoxic antibiotics (p = 0.037) were statistically significantly correlated with the development of postoperative KD and failure to gain the preoperative renal function.
CONCLUSION
We conclude that every patient with risk factor for postoperative KD should be under closed evaluation and monitoring.
背景
本回顾性研究旨在确定肾功能障碍（KD）的发生率，并确定导致择期或急诊手术后骨科患者发生 KD 的潜在危险因素。
方法
在一年的时间内，共有 1025 名患者因各种原因在我院住院。其中 893 名患者（87.1%）接受了手术治疗。患者中有 42 名（52.5%）男性和 38 名（47.5%）女性，平均年龄为 72 岁（范围：47 至 87 岁）。我们评估了以下潜在危险因素：年龄、合并症、休克、低血压、心力衰竭、药物（抗生素、非甾体抗炎药、阿片类药物）、横纹肌溶解症、造影剂和先前存在的 KD。
结果
KD 的总发生率为 8.9%。68 名患者发生急性肾损伤（AKI），12 名患者发生急性和慢性肾脏病（CKD）。在 66 名（82.5%）患者中，肾功能恢复到术前初始状态。围手术期脱水（p=0.002）、糖尿病史（p=0.003）、先前存在的 KD（p=0.004）、围手术期休克（p=0.021）和非甾体抗炎药（NSAIDs）（p=0.028）或肾毒性抗生素（p=0.037）的使用与术后 KD 的发生和无法恢复术前肾功能显著相关。
结论
我们得出结论，每例存在术后 KD 危险因素的患者均应进行密切评估和监测。
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