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2017 ; 7
(1
): 4245
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The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in
Neurosurgical Critically Ill Patients
#MMPMID28652590
Deng Y
; Yuan J
; Chi R
; Ye H
; Zhou D
; Wang S
; Mai C
; Nie Z
; Wang L
; Zhai Y
; Gao L
; Zhang D
; Hu L
; Deng Y
; Chen C
Sci Rep
2017[Jun]; 7
(1
): 4245
PMID28652590
show ga
We investigated the incidence, perioperative risk factors, and outcomes of
postoperative acute kidney injury (AKI) in neurosurgical critically ill patients.
A prospective multicenter cohort study was conducted, enrolling adult patients
who underwent neurosurgical procedure and admitted to the neurosurgical intensive
care units (ICU). Postoperative AKI was diagnosed within 7 days after surgery
based on the Kidney Disease Improving Global Outcomes criteria. Of 624 enrolled
patients, postoperative AKI occurred in 84 patients. AKI was associated with
increased rates of ICU and in-hospital mortality, postoperative renal replacement
therapy, postoperative tracheotomy, and postoperative tracheal reintubation.
Patients who developed AKI had higher total ICU costs, prolonged length of
hospital and ICU stay, and longer duration of postoperative mechanical
ventilation. Multivariate analysis identified postoperative reoperation (adjusted
odds ratio [OR] 5.70 [95% CI, 1.61-20.14]), postoperative concentration of serum
cystatin C (adjusted OR 4.53 [95% CI, 1.98-10.39]), use of mannitol during
operation (adjusted OR 1.97 [95% CI, 1.13-3.43]), postoperative APACHE II score
(adjusted OR 1.11 [95% CI, 1.06-1.16]), and intraoperative estimated blood loss
(adjusted OR 1.04 [95% CI, 1.00-1.08]) as independent risk factors for
postoperative AKI. Postoperative AKI in neurosurgical critically ill cohort is
prevalent and associated with adverse in-hospital outcomes.