Why the study?
The study sought to identify pre-operative risk factors for acute kidney injury in surgical patients aged 65 years and over.
What pre-operative factors are associated with the occurrence of acute kidney injury in patients aged 65 years and over undergoing non-ambulatory non-cardiac surgery?
What pre-operative factors are associated with the occurrence of acute kidney injury in patients aged 65 years and over undergoing non-ambulatory non-cardiac surgery?
Pre-operative creatinine, respiratory insufficiency, and prior vascular or abdominal surgery are significant predictors of post-operative AKI in older adults undergoing non-cardiac surgery, enabling the use of a predictive nomogram.
May inform pre-op AKI risk stratification in elderly patients; hypothesis-generating and requires prospective validation before practice change.
This study sought to identify risk factors for acute kidney injury (AKI) from pre-operative variables in a population of subjects aged over 65. Eligible patients were aged 65 years or over who underwent scheduled non-cardiac, non-ambulatory surgery. Patients with a diagnosis of AKI recorded in the hospital’s databases were considered since cases, from which 300 patients with no diagnosis of AKI, were drawn at random as controls. In total, 81 cases of post-operative AKI and 239 controls were identified. The incidence of post-operative AKI was 2.87%. Pre-operative creatinine level (p = 0.0001), a history of respiratory insufficiency (p = 0.04), prior vascular surgery (p = 0.0001) and abdominal surgery (p = 0.03) were associated with an increased risk of AKI after surgery. These four variables calculated a score and developed a nomogram for predicting occurrence of post-operative AKI. A history of renal disease was associated with increased risk of post-operative AKI, predominantly in cases of vascular or abdominal surgery.
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Guglielmo et al. (2022) studied this question.
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