Assessment of prognostic value of intraoperative oliguria for postoperative acute kidney injury: a retrospective cohort study
| Autor: | Cai Li, Ke-Xuan Liu, Bing-Cheng Zhao, Ya Zhang, Wei-Feng Liu, Xiao Yang, Shao-Hui Lei, Shi-Da Qiu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Oliguria urologic and male genital diseases Likelihood ratios in diagnostic testing Cohort Studies Postoperative Complications Internal medicine Monitoring Intraoperative medicine Humans Risk factor Aged Retrospective Studies business.industry Acute kidney injury Retrospective cohort study Odds ratio Acute Kidney Injury Middle Aged medicine.disease Prognosis Anesthesiology and Pain Medicine Cardiothoracic surgery Female medicine.symptom business Cohort study |
| Zdroj: | British journal of anaesthesia. 126(4) |
| ISSN: | 1471-6771 |
| Popis: | Background Oliguria is often viewed as a sign of renal hypoperfusion and an indicator for volume expansion during surgery. However, the prognostic association and the predictive utility of intraoperative oliguria for postoperative acute kidney injury (AKI) are unclear. Methods We conducted a retrospective cohort study on patients undergoing major thoracic surgery in an academic hospital to assess the association of intraoperative oliguria with postoperative AKI and its predictive value. To contextualise our findings, we included our results in a meta-analysis of observational studies on the importance of oliguria during noncardiac surgery. Results In our cohort study, 3862 patients were included; 205 (5.3%) developed AKI after surgery. Intraoperative urine output of 0.3 ml kg−1 h−1 was the optimal threshold for oliguria in multivariable analysis. Patients with oliguria had an increased risk of AKI (adjusted odds ratio: 2.60; 95% confidence interval: 1.24–5.05). However, intraoperative oliguria had a sensitivity of 5.9%, specificity of 98%, positive likelihood ratio of 2.74, and negative likelihood ratio of 0.96, suggesting poor predictive ability. Moreover, it did not improve upon the predictive performance of a multivariable model, based on discrimination and reclassification indices. Our findings were generally consistent with the results of a systematic review and meta-analysis, including six additional studies. Conclusions Intraoperative oliguria has moderate association with, but poor predictive ability for, postoperative AKI. It remains of clinical interest as a risk factor potentially modifiable to interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|