Küpeli İlke, Ünver Süheyla
Department of Anaesthesiology and Reanimation, Erzincan Binali Yıldırım University School of Medicine, Erzincan, Turkey.
Turk J Anaesthesiol Reanim. 2020 Feb;48(1):38-43. doi: 10.5152/TJAR.2019.65642. Epub 2019 Sep 24.
The aim of the present study was to determine the correlation between preoperative and postoperative hypoalbuminaemia and acute kidney injury (AKI) in the hip fracture surgery in elderly patients.
A total of 160 patients aged ≥65 years were scanned retrospectively. They were grouped into four as the preoperative albumin level of <3.8, preoperative albumin level of >3.8, postoperative day 2 albumin level of <2.9 and postoperative day 2 albumin level of >2.9. In the beginning and 7 days, age, gender, white blood cell, haemoglobin, haematocrit, glucose, blood urea nitrogen, serum creatinine, albumin values, fever, anaesthesia method, presence of blood transfusion, surgical period, hospitalisation durations and expenses in the postoperative period were recorded for all the patients.
In the study, 92 women and 68 men were scanned. AKI was observed in 28 (17.5%) patients, and 16 (57.1%) patients were determined in stage 1. AKI development in Group 1 and Group 3 was significantly high (p<0.05). Advanced age, multiple drug usage, postoperative glucose level and blood product transfusion during the operation were significantly associated with AKI (p<0.05). The hospitalisation period and cost were high in patients with AKI (p<0.05).
It was determined that hypoalbuminaemia was associated with AKI development, and preoperative or postoperative hypoalbuminaemia affected AKI development at similar rates. Advanced age, multiple drug usage, postoperative glucose level and blood product transfusion during the operation were associated with AKI.
本研究旨在确定老年患者髋部骨折手术中术前和术后低蛋白血症与急性肾损伤(AKI)之间的相关性。
回顾性扫描了160例年龄≥65岁的患者。根据术前白蛋白水平<3.8、术前白蛋白水平>3.8、术后第2天白蛋白水平<2.9和术后第2天白蛋白水平>2.9将他们分为四组。在开始时和第7天,记录所有患者的年龄、性别、白细胞、血红蛋白、血细胞比容、血糖、血尿素氮、血清肌酐、白蛋白值、发热、麻醉方法、输血情况、手术时间、住院时间以及术后费用。
本研究共扫描了92名女性和68名男性。28例(17.5%)患者发生了AKI,其中16例(57.1%)患者处于1期。第1组和第3组中AKI的发生率显著较高(p<0.05)。高龄、多种药物使用、术后血糖水平以及手术期间的血液制品输血与AKI显著相关(p<0.05)。AKI患者的住院时间和费用较高(p<0.05)。
确定低蛋白血症与AKI的发生有关,术前或术后低蛋白血症以相似的速率影响AKI的发生。高龄、多种药物使用、术后血糖水平以及手术期间的血液制品输血与AKI有关。