Key result
Pre-operative mean arterial blood pressure < 71 mmHg was associated with an increased risk of postoperative acute kidney injury (OR 1.9; 95% CI 1.2-2.9; p=0.005) in adults after scheduled surgery.
Why the study?
Is pre-operative mean arterial blood pressure < 71 mmHg associated with reduced postoperative kidney function and acute kidney injury in adults undergoing scheduled surgery?
Cohort (n=41,523)
No
Is pre-operative mean arterial blood pressure < 71 mmHg associated with reduced postoperative kidney function and acute kidney injury in adults undergoing scheduled surgery?
Pre-operative mean arterial blood pressure < 71 mmHg is independently associated with reduced postoperative eGFR and an increased risk of acute kidney injury in adults undergoing scheduled surgery.
These associations should not yet change practice; leaves open whether modifying factors improves postoperative renal outcomes.
Summary We used multivariate analyses to assess the association of pre‐operative variables with kidney function in 41,523 adults after scheduled surgery in a single large academic hospital. Eight variables were independently associated with a reduction in postoperative estimated glomerular filtration rate: pre‐operative renal function; age; ASA physical status; cardiac failure; anaemia; cancer; type of surgery; and the lowest quartile of pre‐operative mean arterial blood pressure (< 71 mmHg). The estimated glomerular filtration rate fell by a mean (95% CI ) of 2.7 (0.04–5.40) ml.min −1 .1.73 m −2 for patients with a pre‐operative mean arterial pressure < 71 mmHg, p = 0.047. The same variables and male sex were associated with postoperative acute kidney injury. The odds ratio (95% CI ) for acute postoperative kidney injury was 1.9 (1.2–2.9) for patients with a pre‐operative mean arterial blood pressure < 71 mmHg, p = 0.005.
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Kendale et al. (2016) conducted a cohort in Scheduled surgery (n=41,523). Pre-operative mean arterial blood pressure < 71 mmHg vs. Pre-operative mean arterial blood pressure ≥ 71 mmHg was evaluated on Postoperative acute kidney injury (OR 1.9, 95% CI 1.2-2.9, p=0.005). Pre-operative mean arterial blood pressure < 71 mmHg was associated with an increased risk of postoperative acute kidney injury (OR 1.9; 95% CI 1.2-2.9; p=0.005) in adults after scheduled surgery.
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