Postoperative renal morbidity and mortality after volume replacement with hydroxyethyl starch 130/0.4 or albumin during surgery: a propensity score-matched study
| Autor: | Yoshifumi Kotake, Hideki Miyao |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Propensity score Plasma Substitutes Hydroxyethyl starch Hydroxyethyl Starch Derivatives 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Albumins Anesthesiology Humans Medicine Retrospective Studies business.industry Albumin Incidence (epidemiology) Acute kidney injury 030208 emergency & critical care medicine Perioperative Acute Kidney Injury medicine.disease Surgery Anesthesiology and Pain Medicine Anesthesia Propensity score matching Mann–Whitney U test Fluid Therapy Original Article Female Morbidity business medicine.drug |
| Zdroj: | Journal of Anesthesia |
| ISSN: | 1438-8359 0913-8668 |
| Popis: | Purpose We aimed to compare retrospectively the rates of renal morbidity and mortality in surgical patients receiving 6% HES 130/0.4 to those receiving albumin. Methods From a Japanese nationwide medical database between 2014 and 2016, we identified adults who received HES 130/0.4 (HES group) or albumin (albumin group) as a single colloid solution on the day of surgery. After propensity score matching, the two groups were analyzed with χ2 or Mann Whitney U test. The primary outcome was the incidence of acute kidney injury (AKI). Secondary outcomes included the incidence of renal-replacement therapy, hospital length of stay, in-hospital 30-day mortality, the use of vasoactive agents, and the fluid requirement on the day of surgery. Results Of 76,048 patients in the database, propensity score matching identified 289 matched pairs. There was no statistically significant difference in the incidence of AKI between the HES and the albumin group (15.2% vs. 20.8%, respectively: P = 0.08). The secondary outcomes did not differ between groups except the following. Median hospital stay was 5 days shorter in the HES group (18 vs. 23 days; P P = 0.01). Conclusions Postoperative renal morbidity and mortality did not differ between patients receiving HES 130/0.4 and those receiving albumin. HES 130/0.4 was associated with shorter hospital stay and less fluid requirement compared to albumin. These findings support the use of 6% HES 130/0.4 for perioperative volume replacement as an alternative to albumin. Trial registration UMIN000027896 and the date of registration was June 30, 2017 at https://www.umin.ac.jp/ctr/index-j.html. |
| Databáze: | OpenAIRE |
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