Department of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, İzmir, Turkey.
Department of Orthopaedics and Traumatology, Dokuz Eylül University, School of Medicine, İzmir, Turkey.
Acta Orthop Traumatol Turc. 2022 Jul;56(4):289-295. doi: 10.5152/j.aott.2022.22048.
This study aimed to analyze the frequency of postoperative kidney injury, the related factors, and its effect on outcomes in major orthopedic surgery cases treated in the postanesthesia intensive care unit (PACU).
Major orthopedic surgery cases treated in the PACU were included in this study retrospectively. Demographic, operation, and anesthesia characteristics, CCI, ASA risk classes, preoperative biochemistry, and hemogram results of the patients were recorded. Postoperative serum creatinine level, urine output, renal replacement therapy requirement, and hemoglobin levels were recorded. The kidney damage of the patients was evaluated with RIFLE and AKIN criteria. Postoperative complications were recorded.
The frequency of kidney injury in the early postoperative period was 7.1%. When only arthroplasty cases were taken, the frequency was 11%. It was determined that there was a correlation between preoperative ASA, CCI, BMI, K levels, lactate levels, and postoperative kidney damage (P <0.05). It was determined that the frequency and duration of inotropic use, the frequency and duration of noninvasive mechanical ventilation, and the duration of hospitalization increased in patients with postoperative kidney damage, and the frequency of pneumonia, wound infection, atelectasis, sepsis, arrhythmia, atrial fibrillation and mortality increased in the postoperative period (P <0.05).
There is a need for further studies on the relationship between ASA, CCI, BMI, K, and lactate values and postoperative kidney damage. Postoperative kidney injury is associated with prolonged hospitalization and increased morbidity and mortality.
Level IV, Therapeutic Study.
本研究旨在分析全身麻醉后重症监护病房（PACU）中骨科大手术患者术后肾损伤的发生频率、相关因素及其对结局的影响。
本研究回顾性纳入 PACU 中接受骨科大手术治疗的患者。记录患者的人口统计学、手术和麻醉特征、CCI、ASA 风险分级、术前生化和血常规结果。记录术后血清肌酐水平、尿量、肾脏替代治疗需求和血红蛋白水平。采用 RIFLE 和 AKIN 标准评估患者的肾损伤情况。记录术后并发症。
术后早期肾损伤的发生率为 7.1%。仅考虑关节置换病例时，发生率为 11%。确定术前 ASA、CCI、BMI、K 水平、乳酸水平与术后肾损伤之间存在相关性（P<0.05）。术后肾损伤患者的儿茶酚胺类药物使用频率和时间、无创机械通气频率和时间以及住院时间延长，且术后肺炎、伤口感染、肺不张、脓毒症、心律失常、心房颤动和死亡率增加（P<0.05）。
需要进一步研究 ASA、CCI、BMI、K 和乳酸值与术后肾损伤之间的关系。术后肾损伤与住院时间延长和发病率及死亡率增加相关。
IV 级，治疗性研究。
