Novis B K, Roizen M F, Aronson S, Thisted R A
Department of Anesthesia and Critical Care, University of Chicago, IL 60637.
Anesth Analg. 1994 Jan;78(1):143-9. doi: 10.1213/00000539-199401000-00023.
We performed a systematic review of 28 studies that examined preoperative risk factors for postoperative renal failure. Included in the studies were 10,865 patients who underwent either vascular, cardiac, general, or biliary surgery. No two studies used the same criteria for acute renal failure. Variability in definitions of renal failure, lack of consistent criteria for establishing risk factors, and nonuniformity in the statistical methods employed result in a literature that is not adequate to support a comprehensive quantitative review. Of the 30 variables considered in the studies, preoperative renal risk factors, such as increased serum creatinine, increased blood urea nitrogen, and preoperative renal dysfunction were repeatedly found to predict postoperative renal dysfunction. The literature provides little quantitative information concerning the degree of risk associated with other factors. Cardiac risk factors, such as left ventricular dysfunction, were reported to be predictive of postoperative renal failure more consistently than was advanced age.
我们对28项研究进行了系统评价，这些研究探讨了术后肾衰竭的术前危险因素。这些研究共纳入了10865例接受血管、心脏、普通或胆道手术的患者。没有两项研究使用相同的急性肾衰竭标准。肾衰竭定义的差异、确定危险因素缺乏一致标准以及所采用统计方法的不一致，导致现有文献不足以支持全面的定量综述。在这些研究中考虑的30个变量中，术前肾危险因素，如血清肌酐升高、血尿素氮升高和术前肾功能不全，反复被发现可预测术后肾功能不全。现有文献几乎没有提供关于其他因素相关风险程度的定量信息。心脏危险因素，如左心室功能不全，据报道比高龄更能持续预测术后肾衰竭。
