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Báo cáo y học: "Who is at increased risk for acute kidney injury following noncardiac surger"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Who is at increased risk for acute kidney injury following noncardiac surgery? | Available online http ccforum.eom content 13 4 171 Commentary Who is at increased risk for acute kidney injury following noncardiac surgery Patrick Murray Professor UCD School of Medicine and Medical Science Consultant in Nephrology and Clinical Pharmacology Mater Misericordiae University Hospital Nelson Street Dublin 7 Ireland Corresponding author Patrick Murray patrick.murray@ucd.ie Published 30 July 2009 This article is online at http ccforum.com content 13 4 171 2009 BioMed Central Ltd Critical Care 2009 13 171 doi 10.1186 cc7942 See related research by Abelha et al. http ccforum.com content 13 3 R79 Abstract Abelha and colleagues evaluated the incidence and determinants of postoperative acute kidney injury AKI after major noncardiac surgery in patients with previously normal renal function. In this retrospective study of 1 166 patients with no previous renal insufficiency who were admitted to a postsurgical intensive care unit ICU over a 2-year period the incidence of AKI was 7.5 . Multivariate analysis identified American Society of Anesthesiologists physical status Revised Cardiac Risk Index high-risk surgery and congestive heart disease as preoperative AKI risk factors. AKI was an independent risk factor for hospital mortality odds ratio 3.12 95 confidence interval 1.41 to 6.93 P 0.005 and was associated with higher severity of illness scores Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II longer ICU length of stay higher ICU mortality increased hospital mortality and higher mortality at 6month follow up. Although the study design excluded 121 patients with significant preoperative renal insufficiency by design the relatively crude serum creatinine cut-offs used certainly permitted inclusion of numerous patients with preoperative renal impairment. Accordingly the study design failed to quantify the impact of preoperative renal impairment on risk and outcomes of perioperative AKI in noncardiac surgery and this .