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老年患者髋部骨折手术中术前及术后低白蛋白血症与急性肾损伤发生的相关性(根据KDIGO标准)

The Correlation between Preoperative and Postoperative Hypoalbuminaemia and the Development of Acute Kidney Injury with Respect to the KDIGO Criteria in the Hip Fracture Surgery in Elderly Patients.

作者信息

Küpeli İlke, Ünver Süheyla

机构信息

Department of Anaesthesiology and Reanimation, Erzincan Binali Yıldırım University School of Medicine, Erzincan, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2020 Feb;48(1):38-43. doi: 10.5152/TJAR.2019.65642. Epub 2019 Sep 24.

DOI:10.5152/TJAR.2019.65642
PMID:32076678
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7001803/
Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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本文引用的文献

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Injury. 2018 Aug;49(8):1572-1576. doi: 10.1016/j.injury.2018.05.001. Epub 2018 May 2.
2
Association of preoperative hypoalbuminemia with postoperative acute kidney injury in patients undergoing brain tumor surgery: a retrospective study.术前低白蛋白血症与脑肿瘤手术患者术后急性肾损伤的相关性:一项回顾性研究。
J Neurosurg. 2018 Apr;128(4):1115-1122. doi: 10.3171/2016.11.JNS162237. Epub 2017 May 5.
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Early postoperative albumin level following total knee arthroplasty is associated with acute kidney injury: A retrospective analysis of 1309 consecutive patients based on kidney disease improving global outcomes criteria.全膝关节置换术后早期白蛋白水平与急性肾损伤相关:基于改善全球肾脏病预后组织标准对1309例连续患者的回顾性分析
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Hypoalbuminemia Within Two Postoperative Days Is an Independent Risk Factor for Acute Kidney Injury Following Living Donor Liver Transplantation: A Propensity Score Analysis of 998 Consecutive Patients.术后 2 天内低白蛋白血症是活体肝移植后急性肾损伤的独立危险因素:998 例连续患者的倾向评分分析。
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Serum albumin and health in older people: Review and meta analysis.老年人血清白蛋白与健康:综述与荟萃分析
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