Department of Anesthesiology and Reanimation, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
Am J Surg. 2019 Sep;218(3):457-461. doi: 10.1016/j.amjsurg.2019.01.031. Epub 2019 Jan 31.
The aim of this study was to determine the incidence and the perioperative risk factors of acute kidney injury (AKI) using "Kidney Disease: Improving Global Outcomes" (KDIGO) guidelines, in patients with low grade American Society of Anesthesiologists physical status (ASA-PS) undergoing non-cardiac surgery.
In this multicenter, prospective, observational study, 870 surgical patients older than 40 years with ASA-PS I-II who underwent noncardiac surgery, were included. The primary outcome of this study was perioperative AKI defined by the KDIGO criteria.
AKI was detected in 49 (5.63%) of the patients. Multivariate analysis detected the presence of preoperative hypertension (aOR = 0.130; CI = 0.030-0.566; p = 0.007) and intraoperative transfusion of erythrocytes (aOR = 0.076; CI = 0.008-0.752; p = 0.028) as independent predictors of postoperative AKI development.
Approximately, 6% of patients with ASA I-II presenting for noncardiac surgery developed postoperative AKI. Preoperative hypertension and intraoperative erythrocyte transfusion are independent predictors of AKI after non-cardiac surgery in this patient population.
本研究旨在使用“肾脏疾病：改善全球预后”（KDIGO）指南确定行非心脏手术的低级别美国麻醉医师协会身体状况（ASA-PS）患者中急性肾损伤（AKI）的发生率和围手术期危险因素。
在这项多中心、前瞻性、观察性研究中，纳入了 870 名年龄大于 40 岁、ASA-PS I-II 的接受非心脏手术的外科患者。本研究的主要结局为 KDIGO 标准定义的围手术期 AKI。
49 名（5.63%）患者检测到 AKI。多变量分析检测到术前高血压（aOR=0.130；CI=0.030-0.566；p=0.007）和术中输注红细胞（aOR=0.076；CI=0.008-0.752；p=0.028）是术后 AKI 发展的独立预测因素。
大约 6%的行非心脏手术的 ASA I-II 级患者术后发生 AKI。在该患者人群中，术前高血压和术中红细胞输注是非心脏手术后 AKI 的独立预测因素。
