The effects of acute kidney injury in a multicenter cohort of high-risk surgical patients

Henrique Tadashi Katayama, Brenno Cardoso Gomes, Suzana Margareth Ajeje Lobo, Renato Carneiro de Freitas Chaves, Thiago Domingos Corrêa, Murillo Santucci Cesar Assunção, Ary Serpa Neto, Luiz Marcelo Sá Malbouisson, João Manoel Silva-Jr, for the BraSIS study group Investigators

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4 Citations (Scopus)

Abstract

Background and objectives: Patients who develop post-operative acute kidney injury (AKI) have a poor prognosis, especially when undergoing high-risk surgery. Therefore, the objective of this study was to evaluate the outcome of patients with AKI acquired after non-cardiac surgery and the possible risk factors for this complication. Methods: A multicenter, prospective cohort study with patients admitted to intensive care units (ICUs) after non-cardiac surgery was conducted to assess whether they developed AKI. The patients who developed AKI were then compared to non-AKI patients. Results: A total of 29 ICUs participated, of which 904 high-risk surgical patients were involved in the study. The occurrence of AKI in the post-operative period was 15.8%, and the mortality rate of post-operative AKI patients at 28 days was 27.6%. AKI was strongly associated with 28-day mortality (OR = 2.91; 95% CI 1.51–5.62; p = 0.001), and a higher length of ICU and hospital stay (p < 0.001). Independent factors for the risk of developing AKI were pre-operative anemia (OR = 7.01; 95% CI 1.69–29.07), elective surgery (OR = 0.45; 95% CI 0.21–0.97), SAPS 3 (OR = 1.04; 95% CI 1.02–1.06), post-operative vasopressor use (OR = 2.47; 95% CI 1.34–4.55), post-operative infection (OR = 8.82; 95% CI 2.43–32.05) and the need for reoperation (OR= 7.15; 95% CI 2.58–19.79). Conclusion: AKI was associated with the risk of death in surgical patients and those with anemia before surgery, who had a higher SAPS 3, needed a post-operative vasopressor, or had a post-operative infection or needed reoperation were more likely to develop AKI post-operatively.

Original languageEnglish
Pages (from-to)1338-1348
Number of pages11
JournalRenal Failure
Volume43
Issue number1
DOIs
Publication statusPublished - Jan 2021
Externally publishedYes

Keywords

  • Acute kidney injury
  • high risk
  • intensive care unit
  • perioperative
  • risk factors
  • surgery

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