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食管癌手术后急性肾损伤的发生率及危险因素:一项巢式病例对照研究。

Incidence and risk factors of acute kidney injury after esophageal cancer surgery: A nested case-control study.

机构信息

Department of Anesthesiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, China.

Institute for Hospital Management, Tsinghua University, Beijing, 100084, China.

出版信息

Int J Surg. 2017 Mar;39:11-15. doi: 10.1016/j.ijsu.2017.01.043. Epub 2017 Jan 16.

Abstract

BACKGROUND

Acute kidney injury (AKI) has been increasingly recognized as a common and serious postoperative complication. Although many studies have been conducted to investigate postoperative AKI after thoracic surgery, little is known about AKI after esophageal surgery. Thus, we conducted this study to determine the incidence and identify risk factors of postoperative AKI after esophageal cancer surgery.

MATERIALS AND METHODS

A retrospective nested case-control study of patients undergoing elective esophageal cancer surgery between July 2013 and July 2016 in a single tertiary specialized cancer hospital was performed. The primary outcome was development of AKI. Conditional logistic regression analysis was performed to identify independent risk factors for AKI.

RESULTS

Of 2094 patients, 51 (2.4%) developed postoperative AKI after esophageal cancer surgery. In multivariate conditional logistic regression analysis, four risk factors for AKI after esophageal surgery for cancer were identified: preoperative serum creatinine level (OR 1.040; 95% CI 1.012-1.069), duration of surgery (OR 1.009; 95% CI 1.005-1.014), smoking history (OR 3.029; 95% CI 1.092-8.399) and hypertension (OR 6.422; 95% CI 2.736-15.070).

CONCLUSION

Postoperative AKI occurred in 2.4% of patients after esophageal surgery for cancer. Preoperative serum creatinine level, duration of surgery, smoking history and hypertension were independent risk factors for postoperative AKI.

摘要

背景

急性肾损伤(AKI)已越来越被认为是一种常见且严重的术后并发症。尽管已经有许多研究调查了胸外科手术后 AKI 的发生情况,但对于食管癌手术后 AKI 的了解甚少。因此,我们进行了这项研究,以确定食管癌手术后 AKI 的发生率并确定其危险因素。

材料和方法

这是一项在一家专门的癌症治疗中心进行的回顾性巢式病例对照研究,研究对象为 2013 年 7 月至 2016 年 7 月期间接受择期食管癌手术的患者。主要结局是 AKI 的发生。采用条件逻辑回归分析确定 AKI 的独立危险因素。

结果

在 2094 例患者中,51 例(2.4%)在食管癌手术后发生了术后 AKI。多因素条件逻辑回归分析显示,食管癌手术后 AKI 的四个独立危险因素为:术前血清肌酐水平(OR 1.040;95%CI 1.012-1.069)、手术持续时间(OR 1.009;95%CI 1.005-1.014)、吸烟史(OR 3.029;95%CI 1.092-8.399)和高血压(OR 6.422;95%CI 2.736-15.070)。

结论

食管癌手术后 AKI 的发生率为 2.4%。术前血清肌酐水平、手术持续时间、吸烟史和高血压是术后 AKI 的独立危险因素。

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