The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients

Abstract 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 t...

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Autores principales: Yujun Deng, Jie Yuan, Ruibin Chi, Heng Ye, Dong Zhou, Sheng Wang, Cong Mai, Zhiqiang Nie, Lin Wang, Yiling Zhai, Lu Gao, Danqing Zhang, Linhui Hu, Yiyu Deng, Chunbo Chen
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Publicado: Nature Portfolio 2017
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spelling oai:doaj.org-article:4701963d78234fe9b98a69b718a459ff2021-12-02T16:06:54ZThe Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients10.1038/s41598-017-04627-32045-2322https://doaj.org/article/4701963d78234fe9b98a69b718a459ff2017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-04627-3https://doaj.org/toc/2045-2322Abstract 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.Yujun DengJie YuanRuibin ChiHeng YeDong ZhouSheng WangCong MaiZhiqiang NieLin WangYiling ZhaiLu GaoDanqing ZhangLinhui HuYiyu DengChunbo ChenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Yujun Deng
Jie Yuan
Ruibin Chi
Heng Ye
Dong Zhou
Sheng Wang
Cong Mai
Zhiqiang Nie
Lin Wang
Yiling Zhai
Lu Gao
Danqing Zhang
Linhui Hu
Yiyu Deng
Chunbo Chen
The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients
description Abstract 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.
format article
author Yujun Deng
Jie Yuan
Ruibin Chi
Heng Ye
Dong Zhou
Sheng Wang
Cong Mai
Zhiqiang Nie
Lin Wang
Yiling Zhai
Lu Gao
Danqing Zhang
Linhui Hu
Yiyu Deng
Chunbo Chen
author_facet Yujun Deng
Jie Yuan
Ruibin Chi
Heng Ye
Dong Zhou
Sheng Wang
Cong Mai
Zhiqiang Nie
Lin Wang
Yiling Zhai
Lu Gao
Danqing Zhang
Linhui Hu
Yiyu Deng
Chunbo Chen
author_sort Yujun Deng
title The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients
title_short The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients
title_full The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients
title_fullStr The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients
title_full_unstemmed The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients
title_sort incidence, risk factors and outcomes of postoperative acute kidney injury in neurosurgical critically ill patients
publisher Nature Portfolio
publishDate 2017
url https://doaj.org/article/4701963d78234fe9b98a69b718a459ff
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