Key result
Preoperative sepsis increased the odds of developing acute kidney injury within 7 days of non-cardiac paediatric surgery by nearly fourfold (OR 3.52) compared to patients without sepsis.
Why the study?
Defining the problem of acute kidney injury after non-cardiac surgery is necessary to design preventive interventions.
Cohort (n=93)
No
Odds Ratio: 3.52 (95% CI 1.21–10.2)
Absolute Event Rate: 58.3% vs 27.5%
p-value: p=0.021
Perioperative acute kidney injury is common in children undergoing general non-cardiac surgery, with preoperative sepsis being a major predictor associated with increased mortality.
AKI after pediatric non-cardiac surgery warrants vigilance especially with sepsis; leaves open whether targeted prevention improves outcomes.
It is necessary to define the problem of acute kidney injury (AKI) after non-cardiac surgery in order to design interventions to prevent AKI. The study aimed to evaluate the occurrence, determinants and outcome of AKI among children undergoing general (non-cardiac) surgery. This was a prospective cohort study of patients aged ≤ 15 years who had general surgery over 18 months period at a tertiary hospital in Nigeria. AKI was evaluated at 6 and 24 h and within 7 days of surgery. Data were analysed using SPSS version 21. A total of 93 patients were studied with age ranging from 3 days to 15 years (median = 4 years). AKI occurred within 24 h of surgery in 32 (34.4%) and cumulatively over 7 days in 33 (35.5%). Patients who had sepsis were nearly four times as likely as others to develop perioperative AKI (OR = 3.52, 95% CI 1.21, 10.20, p = 0.021). Crude mortality rate was 12.1% (4/33); no mortality was recorded among those without AKI, p = 0.014. Perioperative AKI occurred in 35.5% of children who underwent general (non-cardiac) surgery. Patients who had sepsis were four times more likely than others to develop AKI. Mortality was documented only in patients who had AKI.
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Lawal et al. (2019) conducted a cohort in Acute kidney injury (n=93). Preoperative sepsis vs. No preoperative sepsis was evaluated on Cumulative acute kidney injury (AKI) within 7 days of surgery (OR 3.52, 95% CI 1.21-10.20, p=0.021). Preoperative sepsis increased the odds of developing acute kidney injury within 7 days of non-cardiac paediatric surgery by nearly fourfold (OR 3.52) compared to patients without sepsis.
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