Incidence and outcomes of AKI in postoperative patients admitted to ICU using full KDIGO criteria - a cohort study
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: Acute kidney injury (AKI) is a serious complication in postoperative ICU patients. The incidence of AKI varies substantially based on the type of surgery and definition used. This study focuses on the incidence of AKI in postoperative ICU patients using full KDIGO criteria and related outcomes regarding to different types of surgery.
DESIGN: Retrospective cohort study.
SETTING: Tertiary level university hospital, eight anaesthesiological/surgical ICUs, between 2016 and 2018.
PATIENTS: 6261 adult patients.
MEASUREMENTS: Primary outcome was 28-day all-cause mortality in different stages of AKI according to complete KDIGO criteria.
MAIN RESULTS: We found 3497 (55.9%) postoperative ICU patients with AKI. The severity distribution of AKI stage 1 to 3 was 19.7%, 28.4% and 7.8%, respectively, and 235 (4%) patients received RRT. The 28-day mortality was 3% (n = 205). Increasing AKI severity was associated with increased 28-day mortality when adjusted for other variables (AKI 2°: OR 2.81; 95% CI 1.55 to 5.24; p < 0.001 and AKI 3°: OR 11.37.; 95% CI 5.91 to 22.55; p < 0.001). Besides AKI stages 2 and 3, age (OR 1.02; 95% CI 1.01 to 1.04, p < 0.001), NYHA IV (OR 2.23; 95% CI 1.03 to 4.43, p = 0.042), need for surgical reintervention within 48 h (OR 2.92; 95% CI 1.76 to 4.72, p = 0.001), urgent surgery (OR 1.78; 95% CI 1.15 to 2.71, p = 0.01), emergency surgery (OR 2.63; 95% CI 1.58 to 4.31, p = 0.001), vascular surgery (OR 2.01; 95% CI 1.06 to 3.98, p = 0.033), and orthopedic and trauma surgery (OR 3.79; 95% CI 1.98 to 7.09, p < 0.001) versus cardiac surgery was significantly associated with increased risk for 28-days mortality in multivariate analysis.
CONCLUSION: AKI based on full KDIGO criteria is very common in postoperative ICU patients and it is associated with stepwise increase in 28-days mortality.
| Errataetall: |
CommentIn: J Clin Anesth. 2024 Feb;92:111188. - PMID 37407305 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:89 |
|---|---|
| Enthalten in: |
Journal of clinical anesthesia - 89(2023) vom: 01. Okt., Seite 111156 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Schiefer, Judith [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute kidney injury |
|---|
| Anmerkungen: |
Date Completed 10.07.2023 Date Revised 28.11.2023 published: Print-Electronic CommentIn: J Clin Anesth. 2024 Feb;92:111188. - PMID 37407305 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jclinane.2023.111156 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM358575605 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM358575605 | ||
| 003 | DE-627 | ||
| 005 | 20231226075036.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jclinane.2023.111156 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1195.xml |
| 035 | |a (DE-627)NLM358575605 | ||
| 035 | |a (NLM)37356195 | ||
| 035 | |a (PII)S0952-8180(23)00106-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Schiefer, Judith |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Incidence and outcomes of AKI in postoperative patients admitted to ICU using full KDIGO criteria - a cohort study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.07.2023 | ||
| 500 | |a Date Revised 28.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Clin Anesth. 2024 Feb;92:111188. - PMID 37407305 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: Acute kidney injury (AKI) is a serious complication in postoperative ICU patients. The incidence of AKI varies substantially based on the type of surgery and definition used. This study focuses on the incidence of AKI in postoperative ICU patients using full KDIGO criteria and related outcomes regarding to different types of surgery | ||
| 520 | |a DESIGN: Retrospective cohort study | ||
| 520 | |a SETTING: Tertiary level university hospital, eight anaesthesiological/surgical ICUs, between 2016 and 2018 | ||
| 520 | |a PATIENTS: 6261 adult patients | ||
| 520 | |a MEASUREMENTS: Primary outcome was 28-day all-cause mortality in different stages of AKI according to complete KDIGO criteria | ||
| 520 | |a MAIN RESULTS: We found 3497 (55.9%) postoperative ICU patients with AKI. The severity distribution of AKI stage 1 to 3 was 19.7%, 28.4% and 7.8%, respectively, and 235 (4%) patients received RRT. The 28-day mortality was 3% (n = 205). Increasing AKI severity was associated with increased 28-day mortality when adjusted for other variables (AKI 2°: OR 2.81; 95% CI 1.55 to 5.24; p < 0.001 and AKI 3°: OR 11.37.; 95% CI 5.91 to 22.55; p < 0.001). Besides AKI stages 2 and 3, age (OR 1.02; 95% CI 1.01 to 1.04, p < 0.001), NYHA IV (OR 2.23; 95% CI 1.03 to 4.43, p = 0.042), need for surgical reintervention within 48 h (OR 2.92; 95% CI 1.76 to 4.72, p = 0.001), urgent surgery (OR 1.78; 95% CI 1.15 to 2.71, p = 0.01), emergency surgery (OR 2.63; 95% CI 1.58 to 4.31, p = 0.001), vascular surgery (OR 2.01; 95% CI 1.06 to 3.98, p = 0.033), and orthopedic and trauma surgery (OR 3.79; 95% CI 1.98 to 7.09, p < 0.001) versus cardiac surgery was significantly associated with increased risk for 28-days mortality in multivariate analysis | ||
| 520 | |a CONCLUSION: AKI based on full KDIGO criteria is very common in postoperative ICU patients and it is associated with stepwise increase in 28-days mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Acute kidney injury | |
| 650 | 4 | |a Incidence | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Postoperative intensive care | |
| 700 | 1 | |a Bernardi, Martin H |e verfasserin |4 aut | |
| 700 | 1 | |a Lichtenegger, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Schak, Gerhard |e verfasserin |4 aut | |
| 700 | 1 | |a Atallah, Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Ristl, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Ramazanova, Dariga |e verfasserin |4 aut | |
| 700 | 1 | |a Faybik, Peter |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of clinical anesthesia |d 1996 |g 89(2023) vom: 01. Okt., Seite 111156 |w (DE-627)NLM013003399 |x 1873-4529 |7 nnns |
| 773 | 1 | 8 | |g volume:89 |g year:2023 |g day:01 |g month:10 |g pages:111156 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jclinane.2023.111156 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 89 |j 2023 |b 01 |c 10 |h 111156 | ||