Lee Eun-Ho, Kim Hyeong Ryul, Baek Seung-Hee, Kim Kyung-Mi, Chin Ji-Hyun, Choi Dae-Kee, Kim Wook-Jong, Choi In-Cheol
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Cardiothorac Vasc Anesth. 2014 Aug;28(4):936-42. doi: 10.1053/j.jvca.2013.12.006. Epub 2014 Mar 27.
The purpose of this study was to identify perioperative risk factors for postoperative acute kidney injury (AKI) in patients undergoing esophageal cancer surgery.
A retrospective analysis of the prospectively collected medical data.
A tertiary care university hospital.
All consecutive adult patients (n=595) who underwent elective esophageal surgery for cancer between January 2005 and April 2012.
None.
AKI was defined by the AKI Network criteria based on serum creatinine changes within the first 48 hours after esophageal cancer surgery. The relationship between perioperative variables and AKI was evaluated using multivariate logistic regression. Postoperative AKI developed in 210 (35.3%) patients. Risk factors for AKI were body mass index (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.01-1.14), preoperative serum albumin level (OR 0.52; 95% CI 0.33-0.84), use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers (OR 1.35; 95% CI 1.05-1.75), colloid infusion during surgery (OR 1.11; 95% CI 1.06-1.18), and postoperative 2-day C-reactive protein (OR 1.05; 95% CI 1.01-1.09). Postoperative AKI was associated with prolonged length of hospital stay.
Postoperative AKI is common in patients undergoing esophageal surgery for cancer. Closer evaluation and monitoring in patients with risk factors for AKI may be warranted.
本研究旨在确定接受食管癌手术患者术后急性肾损伤（AKI）的围手术期危险因素。
对前瞻性收集的医疗数据进行回顾性分析。
一家三级护理大学医院。
2005年1月至2012年4月期间所有连续接受择期食管癌手术的成年患者（n = 595）。
无。
AKI根据AKI网络标准，基于食管癌手术后48小时内血清肌酐变化来定义。使用多因素逻辑回归评估围手术期变量与AKI之间的关系。210例（35.3%）患者发生术后AKI。AKI的危险因素包括体重指数（比值比[OR] 1.07；95%置信区间[CI] 1.01 - 1.14）、术前血清白蛋白水平（OR 0.52；95% CI 0.33 - 0.84）、使用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂（OR 1.35；95% CI 1.05 - 1.75）、手术期间胶体输注（OR 1.11；95% CI 1.06 - 1.18）以及术后2天的C反应蛋白（OR 1.05；95% CI 1.01 - 1.09）。术后AKI与住院时间延长相关。
接受食管癌手术的患者术后AKI很常见。对于有AKI危险因素的患者，可能需要进行更密切的评估和监测。
