Journal
BMC NEPHROLOGY
Volume 23, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12882-022-02675-0
Keywords
Acute kidney injury; Emergency surgery; Critically ill patients; Risk factor; Prognosis
Categories
Funding
- Office of Talent Work Leading Group in Maoming [[2020]24]
- Guangzhou Science and Technology Program [201803010058]
- National Natural Science Foundation of China [82172162]
- Major Program of Summit Project, Guangdong Province High-level Hospital Construction Project of Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences [DFJH2020028]
- Emergent Science and Technology Project for Prevention and Treatment of Novel Coronavirus Pneumonia [2020YJ01]
- High-level Hospital Construction Research Project of Maoming People's Hospital [zx2020017]
- High-level Hospital Construction Research Project of Maoming People's Hospital
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In a study of 383 critically ill patients undergoing emergency surgery, postoperative reoperation, postoperative APACHE II score, and postoperative serum lactic acid were identified as independent risk factors for postoperative AKI, with higher mortality rates and costs in the AKI group.
Background Without sufficient evidence in postoperative acute kidney injury (AKI) in critically ill patients undergoing emergency surgery, it is meaningful to explore the incidence, risk factors, and prognosis of postoperative AKI. Methods A prospective observational study was conducted in the general intensive care units (ICUs) from January 2014 to March 2018. Variables about preoperation, intraoperation and postoperation were collected. AKI was diagnosed using the Kidney Disease: Improving Global Outcomes criteria. Results Among 383 critically ill patients undergoing emergency surgery, 151 (39.4%) patients developed postoperative AKI. Postoperative reoperation, postoperative Acute Physiology and Chronic Health Evaluation (APACHE II) score, and postoperative serum lactic acid (LAC) were independent risk factors for postoperative AKI, with the adjusted odds ratio (ORadj) of 1.854 (95% confidence interval [CI], 1.091-3.152), 1.059 (95%CI, 1.018-1.102), and 1.239 (95%CI, 1.047-1.467), respectively. Compared with the non-AKI group, duration of mechanical ventilation, renal replacement therapy, ICU and hospital mortality, ICU and hospital length of stay, total ICU and hospital costs were higher in the AKI group. Conclusions Postoperative reoperation, postoperative APACHE II score, and postoperative LAC were independent risk factors of postoperative AKI in critically ill patients undergoing emergency surgery.
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