Yu Jihion, Seo Young Joo, Lee Soo Kyung, Oh Minho, Park Jun-Young, Kim Chan-Sik, Kim Young-Kug
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Burns. 2025 Aug;51(6):107533. doi: 10.1016/j.burns.2025.107533. Epub 2025 May 10.
Burn injuries can lead to severe complications across multiple organ systems, with kidney impairment being particularly common and clinically significant. Major adverse kidney events within 30 days post-surgery (MAKE30)-including death, initiation of new renal replacement therapy, or prolonged renal dysfunction-are increasingly used in clinical research to assess mid-term renal outcomes. However, studies on the incidence and risk factors of MAKE30 in burn patients remain limited.
We included burn patients admitted to a single-center burn intensive care unit between 2012 and 2022, excluding those with pre-existing kidney disease. The incidence of MAKE 30 was evaluated, and logistic regression analysis was performed to identify associated risk factors.
Among 848 burn patients who underwent burn surgery during the study period, 286 (33.7 %) developed MAKE30. Postoperative acute kidney injury (AKI), age, diabetes mellitus, inhalation injury, deep burn area, intraoperative vasopressor use, fresh frozen plasma transfusion, and urine output were significantly associated with MAKE30. The incidence of MAKE30 was markedly higher in patients who developed postoperative AKI compared to those who did not (89.6 % vs. 18.3 %, p < 0.001). Additionally, chronic kidney disease (CKD) was significantly more prevalent in patients with MAKE30 than in those without (12.0 % vs. 1.7 %, p < 0.001).
Postoperative AKI is a significant risk factor for MAKE30 following burn surgery, and affected patients exhibit a substantially higher incidence of CKD. This study provides single-center data on incidence and its associated risk factors of MAKE30, underscoring the importance of early kidney function monitoring and intervention in this population.
烧伤可导致多个器官系统出现严重并发症，其中肾脏功能损害尤为常见且具有临床意义。术后30天内的主要不良肾脏事件（MAKE30），包括死亡、开始新的肾脏替代治疗或持续性肾功能障碍，在临床研究中越来越多地用于评估中期肾脏结局。然而，关于烧伤患者MAKE30的发生率和危险因素的研究仍然有限。
我们纳入了2012年至2022年间入住单中心烧伤重症监护病房的烧伤患者，排除了既往有肾脏疾病的患者。评估MAKE30的发生率，并进行逻辑回归分析以确定相关危险因素。
在研究期间接受烧伤手术的848例烧伤患者中，286例（33.7%）发生了MAKE30。术后急性肾损伤（AKI）、年龄、糖尿病、吸入性损伤、深度烧伤面积、术中使用血管升压药、输注新鲜冰冻血浆和尿量与MAKE30显著相关。发生术后AKI的患者MAKE30的发生率明显高于未发生者（89.6%对18.3%，p<0.001）。此外，MAKE30患者慢性肾脏病（CKD）的患病率显著高于未发生者（12.0%对1.7%，p<0.001）。
术后AKI是烧伤手术后MAKE30的重要危险因素，受影响患者的CKD发生率显著更高。本研究提供了关于MAKE30发生率及其相关危险因素的单中心数据，强调了在该人群中早期肾功能监测和干预的重要性。
