Flurbiprofen axetil administration during both intraoperative and postoperative periods significantly reduced the odds of acute kidney injury by 39% (OR 0.61) compared to non-use in patients undergoing non-cardiac surgery.
Cohort (n=45,062)
No
Does perioperative flurbiprofen axetil administration reduce acute kidney injury in adult patients undergoing non-cardiac surgery?
Perioperative flurbiprofen axetil administration is associated with a reduced risk of postoperative acute kidney injury and shorter length of stay in patients undergoing non-cardiac surgery.
Effect estimate: OR 0.61 (95% CI 0.51-0.73)
Absolute Event Rate: 3.5% vs 8.2%
p-value: p=<0.001
Purpose: This study aims to evaluate the impact of different timing of flurbiprofen axetil (FA) administration on postoperative acute kidney injury (AKI) and other adverse events in non-cardiac surgery patients. Patients and Methods: This retrospective cohort study included 45,062 adult patients undergoing non-cardiac surgery from January 1, 2019, to October 31, 2023. Perioperative FA analgesia records were extracted from electronic medical records. The primary outcome was AKI within 7 days after surgery. Secondary outcomes included postoperative adverse cardiovascular events (ACE), postoperative length of stay (LOS), and in-hospital mortality. Results: The incidences of AKI, ACE, and mortality were 6.0% (2,683/45,062), 8.5% (3,809/45,062), and 0.1% (48/45,062), respectively. Intraoperative odds ratio (OR), 0.71; 95% confidence interval (CI), 0.62– 0.82 and postoperative (OR, 0.73; 95% CI, 0.66– 0.79) FA administration was associated with lower odds of AKI compared with non-use. Compared to patients who did not receive FA analgesia at any point, those who received FA both during and post-surgery had a significantly lower odds of AKI (OR, 0.61; 95% CI, 0.51– 0.73). Subgroup analysis indicated a greater reduction in AKI odds for intraoperative FA administration in patients with a high inflammatory status (OR and 95% CI: 0.58 0.47– 0.72 vs 0.84 0.59– 1.20, P for interaction = 0.010). Postoperative, but not intraoperative FA administration, was associated with a lower odds of ACE (OR, 0.85; 95% CI, 0.79– 0.91), with this association was significant in patients without preoperative hypertension (OR and 95% CI: 0.81 0.74– 0.88 vs 0.96 0.81– 1.13, P for interaction< 0.05). Accelerated failure time model showed that both intraoperative and postoperative FA use was inversely correlated with postoperative LOS. Conclusion: Perioperative FA analgesia was associated with a lower odds of postoperative AKI and shorter postoperative LOS, whereas only postoperative FA analgesia was linked to a lower odds of postoperative ACE. Keywords: flurbiprofen axetil, acute kidney injury, adverse cardiovascular events, perioperative analgesia, postoperative complications
Wang et al. (Wed,) conducted a cohort in Non-cardiac surgery (n=45,062). Flurbiprofen axetil vs. Non-use was evaluated on Acute kidney injury (AKI) within 7 days after surgery (OR 0.61, 95% CI 0.51-0.73, p=<0.001). Flurbiprofen axetil administration during both intraoperative and postoperative periods significantly reduced the odds of acute kidney injury by 39% (OR 0.61) compared to non-use in patients undergoing non-cardiac surgery.