Key result
Postoperative acute kidney injury was associated with a significantly increased risk of one-year mortality (18.6% vs 1.9%; HR 6.69) compared to no acute kidney injury after plastic surgery.
Why the study?
Although AKI is a known independent risk factor for mortality in major surgeries, its effect on postoperative outcomes after plastic and reconstructive surgery had not been evaluated.
Does postoperative acute kidney injury increase mortality in adult patients undergoing plastic and reconstructive surgery?
Cohort (n=7,059)
No
Does postoperative acute kidney injury increase mortality in adult patients undergoing plastic and reconstructive surgery?
Hazard Ratio: 6.69 (95% CI 2.65–16.85)
Absolute Event Rate: 18.6% vs 1.9%
p-value: p=<0.001
Postoperative acute kidney injury, even when mild, is associated with a significantly increased risk of short- and long-term mortality in patients undergoing plastic and reconstructive surgery.
AKI after plastic surgery was associated with higher mortality; leaves open whether prevention improves survival pending confirmatory trials.
Acute kidney injury (AKI) is a common postoperative disorder that is associated with considerable morbidity and mortality. Although the role of AKI as an independent risk factor for mortality has been well characterized in major surgeries, its effect on postoperative outcomes in plastic and reconstructive surgery has not been evaluated. This study explored the association between postoperative AKI and mortality in patients undergoing plastic and reconstructive surgery. Consecutive adult patients who underwent plastic and reconstructive surgery without end-stage renal disease (n = 7059) at our institution from January 2011 to July 2019 were identified. The patients were divided into two groups according to occurrence of postoperative AKI: 7000 patients (99.2%) in the no AKI group and 59 patients (0.8%) in the AKI group. The primary outcome was mortality during the first year, and overall mortality and 30-days mortality were also compared. After inverse probability weighting, mortality during the first year after plastic and reconstructive surgery was significantly increased in the AKI group (1.9% vs. 18.6%; hazard ratio, 6.69; 95% confidence interval, 2.65-16.85; p < 0.001). In this study, overall and 30-day mortalities were shown to be higher in the AKI group, and further studies are needed on postoperative AKI in plastic and reconstructive surgery.
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Sung et al. (2022) conducted a cohort in Patients undergoing plastic and reconstructive surgery (n=7,059). Postoperative acute kidney injury (AKI) vs. No postoperative acute kidney injury was evaluated on One-year mortality after surgery (HR 6.69, 95% CI 2.65-16.85, p=<0.001). Postoperative acute kidney injury was associated with a significantly increased risk of one-year mortality (18.6% vs 1.9%; HR 6.69) compared to no acute kidney injury after plastic surgery.
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