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Abstract: SA-PO055

Risk Factors and Long-Term Prognosis of Post-Operative AKI under Non-General Anesthesia

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Lee, Soojin, Seoul national university hospital, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University Hospital, Jongno-gu, SEoul, Korea (the Republic of)
  • Lee, Anna, SNUBH, Gyeonggi-do, Korea (the Democratic People's Republic of)
  • Chin, Ho Jun, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
  • Na, Ki Young, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
  • Kim, Sejoong, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
Background

The patients who receive surgeries under non-general anesthesia are less likely to be evaluated for their post-operative acute kidney injury (AKI) risks in detail than patients who undergo major operation. Risk factors and long-term prognosis data of these patients are scarce.

Methods

We conducted a retrospective cohort study on all adult patients who underwent surgeries under non-general anesthesia during the year 2013. Patients who had other surgeries within 1 month from their index operation, those with kidney injury prior to the surgery and those who lacked information of baseline or follow-up serum creatinine (sCr) measurement were excluded. Postoperative AKI was defined as 0.3 mg/dL or 1.5 times elevation of the patients’ sCr from the baseline within 2 weeks from the surgery. Long-term outcomes were a composition of doubling of sCr and eGFR decrement for 30%, at 3 months or 6 months after operation. Risk factors for AKI were evaluated by multivariable logistic regression analyses.

Results

As a result, a number of 1,737 patients were included in our study cohort. Among them, 158 cases experienced post-operative AKI. Most of the AKI cases occurred after pulmonary or orthopedic surgeries with non-general anesthesia. Presence of baseline diabetes mellitus (adjusted OR 1.87, 95% CI 1.27-2.75, P < 0.001) and anemia (hemoglobin < 11 g/dL, adjusted OR 1.76, 95% CI 1.14-2.72, P=0.01) were significant risk factors for the AI events. When the long-term prognosis was evaluated, those who experienced AKI after non-general anesthesia surgeries significantly had worse renal outcomes at 3 month (adjusted OR 5.57, 95% CI 3.28-9.39, P < 0.001) or 6 month (adjusted OR 5.29, 95% CI 2.72-10.19, P < 0.001).

Conclusion

Therefore, postoperative AKI occurs in non-negligible portion of patients who underwent surgeries under non-general anesthesia, and their long-term renal prognoses were worse than of those without the event. Robust evaluation of underlying risk factors for post-operative AKI and careful follow-up for those who developed AKI should be warranted, regardless of anesthesia method used for the surgery.