■急性肾损伤(AKI)在接受大型手术的患者中很常见,并导致需要肾脏替代疗法和增加发病率,重症监护病房(ICU)和住院时间(LOS),成本,和死亡率。我们评估了肝切除术患者术后AKI的发生率和预测因素及其短期预后。
■这项前瞻性观察性研究是在为期3年的时间内对180例接受各种适应症的选择性肝切除术的患者进行的。我们使用急性肾损伤网络标准来确定72小时时AKI的发生率。评估了影响AKI发展的围手术期变量和患者的短期术后结局。
■29.4%的患者术后发生AKI。在五名患者中发现了持续性肾功能不全。AKI的发展与肝功能衰竭有关(18.5vs5.5%,p<0.005),延长ICU(2天vs1天,p<0.001)和医院LOS(11天vs8天,p<0.004),并增加ICU和医院死亡率(9.6vs1.4%,p<0.02)。年龄[OR(优势比)1.033,95%CI(置信区间)1.003-1.065,p=0.03],BMI(体重指数)(OR1.131,95%CI1.043-1.227,p=0.003),术后需要通气(OR3.456,95%CI1.593-7.495,p=0.002)是AKI的独立预测因子。
■选择性肝切除术后近三分之一的患者发生AKI。在五名患者中发现了持续性肾功能不全。年龄,BMI,术后需要通气是术后AKI的独立预测因素。(CTRI注册。不。:CTRI/2016/06/007044)。
■JoshiM,MilmileR,DhakaneP,BhosaleSJ,库尔卡尼美联社。接受选择性肝切除术治疗恶性肿瘤的患者急性肾损伤的发生率和预测因素:一项为期3年的前瞻性观察研究。印度J暴击护理中心2021;25(4):398-404。
UNASSIGNED: Acute kidney injury (AKI) is common in patients undergoing major surgeries, and leads to the need for renal replacement therapy and increased morbidity, intensive care unit (ICU) and hospital length of stay (LOS), cost, and mortality. We evaluated the incidence and predictors of postoperative AKI in patients undergoing hepatic resections and their short-term outcomes.
UNASSIGNED: This prospective observational study was conducted over a 3-year period in 180 patients undergoing elective hepatic resections for a variety of indications. We used the Acute Kidney Injury Network criteria to determine the incidence of AKI at 72 hours. Perioperative variables contributing to the development of AKI and the short-term postoperative outcomes of patients were evaluated.
UNASSIGNED: Postoperative AKI occurred in 29.4% of patients. Persistent renal dysfunction was seen in five patients. Development of AKI was associated with hepatic failure (18.5 vs 5.5%, p < 0.005), prolonged ICU (2 vs 1 days, p < 0.001) and hospital LOS (11 vs 8 days, p < 0.004), and increased ICU and hospital mortality (9.6 vs 1.4%, p < 0.02). Age [OR (odds ratio) 1.033, 95% CI (confidence interval) 1.003-1.065, p = 0.03], BMI (body mass index) (OR 1.131, 95% CI 1.043-1.227, p = 0.003), and need for postoperative ventilation (OR 3.456, 95% CI 1.593-7.495, p = 0.002) were independent predictors of AKI.
UNASSIGNED: AKI after elective hepatic resection occurred in nearly one-third of our patients. Persistent renal dysfunction was seen in five patients. Age, BMI, and need for postoperative ventilation were independent predictors of postoperative AKI. (CTRI reg. No.: CTRI/2016/06/007044).
UNASSIGNED: Joshi M, Milmile R, Dhakane P, Bhosale SJ, Kulkarni AP. Incidence and Predictors of Acute Kidney Injury in Patients Undergoing Elective Hepatic Resection for Malignant Tumors: A 3-year Prospective Observational Study. Indian J Crit Care Med 2021;25(4):398-404.