Impact of intraoperative nonsteroidal anti-inflammatory drugs on acute kidney injury after major noncardiac surgery: a propensity score-matched analysis

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  Figure 1.. Flowchart of patient selection. A total of 29,497 patients were screened, and 11,139 were included after applying exclusion criteria. After propensity score matching, 3,361 matched pairs (6,722 patients) were analyzed. NSAIDs: nonsteroidal anti-inflammatory drugs; eGFR: estimated glomerular filtration rate.

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  Figure 2.. Standardized mean differences (Love plot) of covariates before and after propensity score matching. The dashed line represents the 10% threshold for acceptable balance. SMD: standardized mean difference; PSM: propensity score matching.

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  Figure 3.. Association between NSAIDs administration and postoperative outcomes. Sequentially adjusted logistic regression models (Models 1–4) were used before propensity score matching; the unadjusted model (Model 1) was used after propensity score matching. Model 1: Unadjusted model. Model 2: Adjusted for age, sex, and BMI. Model 3: Model 2 plus comorbidities (hypertension, diabetes, coronary artery disease, chronic heart failure, stroke, COPD, vascular disease), preoperative medications (ACEI/ARB, statins, insulin, diuretics) and baseline serum creatinine, serum albumin, and serum hemoglobin. Model 4: Model 3 plus ASA physical status, operative site, anesthetic approaches, blood loss, blood transfusion, duration of surgery, duration of anesthesia, IOH, fluid balance. AKI: acute kidney injury; aProlonged postoperative hospital stay was defined as ≥7 days between surgery and discharge; OR: odds ratio; CI: confidence interval; NSAIDs: nonsteroidal anti-inflammatory drugs; BMI: body mass index; COPD: chronic obstructive pulmonary disease; ACEI: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor blocker; ASA: American Society of Anesthesiologists; IOH: intraoperative…

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  Figure 4.. Subgroup analyses assessing the interaction between NSAIDs and preoperative risk factors on the incidence of postoperative AKI in the propensity score-matched cohort. NSAIDs: nonsteroidal anti-inflammatory drugs; AKI: acute kidney injury; OR: odds ratio; CI: confidence interval; aHypoalbuminemia was defined as a preoperative serum albumin level <3.5 g·dL−1; bDecreased preoperative renal function was defined as a preoperative serum creatinine level >1.2 mg·dL−1; cIntraoperative hypotension (IOH) was defined as mean arterial pressure (MAP) <65 mmHg; dPreoperative anemia was defined as preoperative serum hemoglobin <100 g·L−1.