The Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, Heilongjiang, China.
The Department of Anesthesiology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelv District, Changsha, Hunan, China.
BMC Anesthesiol. 2022 May 20;22(1):155. doi: 10.1186/s12871-022-01688-4.
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely prescribed drugs worldwide. However, the effect of NSAIDS on postoperative renal function is still unclear. Few studies have assessed the effects of parecoxib on renal function. Our aim is to investigate a correlation between parecoxib and the presence or absence of AKI postoperatively after a breast cancer surgery operation.
This was a retrospective cohort study that we performed on our hospitalized database. From January 2012 to August 2021, 3542 female patients undergoing radical mastectomy were enrolled, all data including the patients' information and laboratory results were obtained from electronic medical system. The main outcome was the incidence of AKI postoperatively. AKI was defined in accordance with the KDIGO criteria. Study groups were treated with or without parecoxib. Univariable and multivariable logistic regression analyses were performed.
In our study, about 5.76% experienced AKI. The incidence rate of postoperative AKI (3.49%) within 7 days in the parecoxib group was lower than that in the control group (6.00%, P = 0.05). Compared to the control group, the AKI's incidence was reduced by 49% (OR = 0.46; 95%CI 0.27-0.97) in parecoxib group in multivariable logistic regression analysis. There was a reduction in the incidence of postoperative AKI in other three subgroups: preoperative eGFR < 90 mL/min·1.73/m2 (OR = 0.52; 95%CI 0.27-0.97), blood loss < 1000 ml (OR = 0.48; 95%CI 0.24-0.96) and non-diabetes (OR = 0.51; 95%CI 0.26-0.98).
Parecoxib was associated with incidence of postoperative acute kidney injury.
非甾体抗炎药（NSAIDs）是全球应用最广泛的药物之一。然而，NSAIDs 对术后肾功能的影响仍不清楚。很少有研究评估帕瑞昔布对肾功能的影响。我们的目的是研究帕瑞昔布与乳腺癌手术后 AKI 的发生或不发生之间的相关性。
这是一项回顾性队列研究，我们在住院患者数据库中进行。2012 年 1 月至 2021 年 8 月，共纳入 3542 例行根治性乳房切除术的女性患者，所有数据包括患者信息和实验室结果均从电子病历系统中获取。主要结局为术后 AKI 的发生率。AKI 按照 KDIGO 标准定义。研究组分别接受帕瑞昔布或安慰剂治疗。进行单变量和多变量逻辑回归分析。
在我们的研究中，约 5.76%的患者发生 AKI。帕瑞昔布组术后 7 天内 AKI 的发生率（3.49%）低于对照组（6.00%，P=0.05）。与对照组相比，帕瑞昔布组 AKI 的发生率降低了 49%（OR=0.46；95%CI 0.27-0.97），多变量逻辑回归分析。在其他三个亚组中，术后 AKI 的发生率也有所降低：术前 eGFR<90 mL/min·1.73/m2（OR=0.52；95%CI 0.27-0.97）、出血量<1000 ml（OR=0.48；95%CI 0.24-0.96）和非糖尿病（OR=0.51；95%CI 0.26-0.98）。
帕瑞昔布与术后急性肾损伤的发生率有关。
