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术后贫血是开放型主动脉和腔静脉手术后急性肾损伤的一个风险因素。

Postoperative anemia is a risk factor for acute kidney injury after open aorta and vena cava surgeries.

机构信息

Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Department of Nephrology, Beijing Haidian Hospital and Beijing Haidian section of Peking University Third Hospital, Beijing, China.

出版信息

PLoS One. 2020 Oct 13;15(10):e0240243. doi: 10.1371/journal.pone.0240243. eCollection 2020.

Abstract

Open aorta and vena cava surgeries are usually associated with substantial blood loss which may result in postoperative acute kidney injury (AKI). The present study is designed to investigate the prevalence, outcome and risk factors of postoperative AKI associated with open aorta and vena cava surgeries, with a focus on the role of anemia in these conditions. A retrospective review of medical records of Peking Union Medical College Hospital was conducted. Patients who underwent open aorta and vena cava surgeries during January 1, 2010 and June 30, 2014 were included in this study. The primary analysis was between patients underwent open aorta and vena cava surgeryies, with or without postoperative AKI. Multivariable logistic regression models were used to determine risk factors of postoperative AKI. The study included 79 patients (63.3% male) with a mean age of 52.5±17.3 years (range, 17-81 years). Postoperative AKI occurred in 23/79 (29.1%) of the patients. Anemia was present in 11/79 (16%) at baseline, and increased to 45/79 (52%) postoperatively. After adjustment for various risk factors, postoperative anemia (OR, 5.202; 95% CI 1.403-19.285) was independently associated with postoperative AKI. AKI is a common complication in patients who undergo open aorta and vena cava surgeries, and postoperative anemia was the most relevant predictive factor of AKI. Strategies to minimize bleeding and anemia for all patients may be advisable. Further studies are needed to assess the impact of AKI on long term outcome and to examine preventive strategies to address potentially modifiable risk factors.

摘要

开放性主动脉和腔静脉手术通常会导致大量失血,从而导致术后急性肾损伤(AKI)。本研究旨在调查与开放性主动脉和腔静脉手术相关的术后 AKI 的患病率、结局和危险因素,重点关注贫血在这些情况下的作用。

对北京协和医学院医院的病历进行了回顾性审查。本研究纳入了 2010 年 1 月 1 日至 2014 年 6 月 30 日期间接受开放性主动脉和腔静脉手术的患者。主要分析是在接受开放性主动脉和腔静脉手术的患者中,有无术后 AKI。多变量逻辑回归模型用于确定术后 AKI 的危险因素。

本研究纳入了 79 例患者(63.3%为男性),平均年龄为 52.5±17.3 岁(范围为 17-81 岁)。79 例患者中,术后 AKI 发生 23 例(29.1%)。基线时有 11 例(16%)患者存在贫血,术后增加至 45 例(52%)。

在调整了各种危险因素后,术后贫血(OR,5.202;95%CI 1.403-19.285)与术后 AKI 独立相关。AKI 是接受开放性主动脉和腔静脉手术患者的常见并发症,术后贫血是 AKI 最相关的预测因素。对于所有患者,应采取策略以尽量减少出血和贫血。需要进一步研究评估 AKI 对长期结局的影响,并研究针对潜在可改变危险因素的预防策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1016/7553320/c0d52f8b97d9/pone.0240243.g001.jpg

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