Abstract
BackgroundWithout 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.MethodsA 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.ResultsAmong 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.ConclusionsPostoperative reoperation, postoperative APACHE II score, and postoperative LAC were independent risk factors of postoperative AKI in critically ill patients undergoing emergency surgery.
Highlights
Acute kidney injury (AKI) is a common postoperative complication, with the incidence ranged from 0.8 to 39% described by previous studies [1,2,3]
151 (39.4%) patients occurred in postoperative acute kidney injury (AKI) basing on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria
Of those patients who evolved into postoperative AKI, 92 patients (60.9%) developed to stage 1, 40 patients (26.5%) were progressed to stage 2, and 19 patients were evolved into stage 3 (12.6%)
Summary
Acute kidney injury (AKI) is a common postoperative complication, with the incidence ranged from 0.8 to 39% described by previous studies [1,2,3]. Research on the incidence, risk factors, and prognosis of postoperative AKI in critically ill patients undergoing emergency surgery was scarce. It might result in an undesired postponement in initial therapies. A greater understanding of morbidity and risk factors of postoperative AKI after emergency surgery might advance timely diagnosis and treatment. 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
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