Key result
In patients undergoing major orthopedic surgery, the incidence of early postoperative acute kidney injury was 7.1%, and a higher baseline Charlson Comorbidity Index was significantly associated with the development of kidney damage (OR 2.278).
Why the study?
The frequency, related risk factors, and impact on outcomes of postoperative kidney injury after major orthopedic surgery treated in the postanesthesia intensive care unit were not well characterized.
Cohort (n=98)
No
Odds Ratio: 2.278 (95% CI 1.3–5.83)
CCI may aid preoperative AKI risk prediction in orthopedic surgery; extends observational data but leaves open prospective validation.
OBJECTIVE: This study aimed to analyze the frequency of postoperative kidney injury, the related factors, and its effect on outcomes in major orthopedic surgery cases treated in the postanesthesia intensive care unit (PACU). METHODS: Major orthopedic surgery cases treated in the PACU were included in this study retrospectively. Demographic, operation, and anesthesia characteristics, CCI, ASA risk classes, preoperative biochemistry, and hemogram results of the patients were recorded. Postoperative serum creatinine level, urine output, renal replacement therapy requirement, and hemoglobin levels were recorded. The kidney damage of the patients was evaluated with RIFLE and AKIN criteria. Postoperative complications were recorded. RESULTS: The frequency of kidney injury in the early postoperative period was 7.1%. When only arthroplasty cases were taken, the frequency was 11%. It was determined that there was a correlation between preoperative ASA, CCI, BMI, K levels, lactate levels, and postoperative kidney damage (P <0.05). It was determined that the frequency and duration of inotropic use, the frequency and duration of noninvasive mechanical ventilation, and the duration of hospitalization increased in patients with postoperative kidney damage, and the frequency of pneumonia, wound infection, atelectasis, sepsis, arrhythmia, atrial fibrillation and mortality increased in the postoperative period (P <0.05). CONCLUSION: There is a need for further studies on the relationship between ASA, CCI, BMI, K, and lactate values and postoperative kidney damage. Postoperative kidney injury is associated with prolonged hospitalization and increased morbidity and mortality. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.
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Hancı et al. (2022) conducted a cohort in Postoperative acute kidney injury (n=98). Charlson Comorbidity Index (CCI) vs. Lower baseline CCI was evaluated on Postoperative acute kidney injury (AKI) (OR 2.278, 95% CI 1.30-5.83). In patients undergoing major orthopedic surgery, the incidence of early postoperative acute kidney injury was 7.1%, and a higher baseline Charlson Comorbidity Index was significantly associated with the development of kidney damage (OR 2.278).
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