Risk factors of acute kidney injury according to RIFLE criteria after lung cancer surgery
| Autor: | Jean-Marie Tschopp, Vanessa Cartier, Yann Villiger, Marc Licker, John Robert, Cigdem Inan, John Diaper |
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| Rok vydání: | 2010 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Lung Neoplasms Lung Neoplasms/surgery urologic and male genital diseases Severity of Illness Index Switzerland/epidemiology Risk Factors Internal medicine Medicine Humans Rifle Risk factor Pneumonectomy/adverse effects Pneumonectomy Aged Retrospective Studies ddc:616 Lung cancer surgery Survival Rate/trends ddc:617 business.industry urogenital system Incidence Acute Kidney Injury/classification/epidemiology/etiology Acute kidney injury Retrospective cohort study Perioperative Odds ratio Acute Kidney Injury Middle Aged medicine.disease female genital diseases and pregnancy complications Surgery Survival Rate Female Cardiology and Cardiovascular Medicine business Switzerland Kidney disease Follow-Up Studies |
| Zdroj: | Annals of Thoracic Surgery, Vol. 91, No 3 (2011) pp. 844-50 |
| ISSN: | 1552-6259 0003-4975 |
| Popis: | Perioperative acute kidney injury (AKI) is associated with increased mortality and morbidity. Our aim was to evaluate the incidence and determinants of AKI using the risk, injury, failure, loss of function, and end-stage kidney disease (RIFLE) criteria in thoracic surgical patients.We retrospectively analyzed a cohort of patients undergoing lung cancer surgery from 1996 to 2009. Patient management was protocol-driven, and postoperative complications were prospectively collected. The primary outcome was AKI within 3 days after surgery. A variety of patient comorbidities and operative characteristics were evaluated as potential predictors of AKI using a multiple logistic regression model.Complete data were obtained from 1,345 patients, and the incidence of AKI was 6.8%. Four independent risk factors for AKI were identified: American Society of Anesthesiologists classes 3 and 4 (odds ratio [OR] 2.60, 95% confidence interval [CI]: 1.03 to 6.55), forced expiratory volume in 1 second (OR 0.55, 95% CI: 0.32 to 0.96), the use of vasopressors (OR 1.015, 95% CI: 0.998 to 1.035), and the duration of anesthesia (OR 1.044, 95% CI: 1.001 to 1.008). Patients who experienced AKI were more frequently admitted to the intensive care unit (24.2% versus 3.5% for patients without AKI, p0.05); they had increased mortality (19.8% versus 1.1%, p0.05) and a threefold to fourfold higher incidence of cardiopulmonary complications.The RIFLE classification is a valuable tool to assess AKI after lung cancer surgery. The severity of perioperative renal impairment is associated with increased mortality and morbidity. |
| Databáze: | OpenAIRE |
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