The Incidence,Risk Factors And Outcomes Of Acute Kidney Injury In Critically Ill Patients Undergoing Emergency Surgery

ObjectiveTo explore the incidence,risk factors and prognosis of AKI in criticaly ill patients undergoing emergency surgery,to clarify the epidemiological status of AKI in critically ill patients in emergency surgery,and to improve the early identification and diagnosis of AKI in critically ill patients,interventions are taken to reduce adverse kidney time and improve prognosis.MethodPreoperative data,intraoperative data,postoperative data and postoperative prognosis data of critically ill patients undergoing emergency surgery in the ICU of Guangdong Provincial People’s Hospital from January 2014 to March 2018 were collected.The diagnosis and staging of AKI was based on the AKI diagnostic criteria proposed by the Global Thorne Disease Prognosis Organization(KDIGO)in 2012.They were divided into two groups according to whether AK1 occurred after surgery:AKI group and non-AKI group.The baseline characteristics,AKI incidence,AKI stage,and in-hospital prognosis in all enrolled patients were analysised prospectively.Logistic multiple regression was used to calculate the independent risk factors for AKI after surgery.Results1.A total of 383 critically ill patients undergoing emergency surgery were enrolled in this study.The median age was 60(49,71)years,including 247 male patients and 136 female patients.Among them,161 patients had hypertension,37 patients had diabetes,and 11 patients had chronic kidney disease(CKD).A total of 151 patients developed AKI after surgery,so the incidence of postoperative AKI in critically ill patients undergoing emergency surgery was 39.4%.2.Logistic multiple regression analysis was performed on the statistically significant variables of the AKI group and the non-AKI group.The results showed:postoperative reoperation(OR=1.854,P=0.022)and postoperative APACHEII score(OR=1.059,P=0.005),postoperative serum lactic acid(OR=1.239,P=0.013),postoperative serum creatinine(OR=3.934,P<0.0001)was an independent risk factor for acute kidney injury in critically ill patients.3.RRT,The ICU mortality,hospital mortality,ICU hospitalization time,total hospital stay,ICU total cost,and total hospitalization expenses were higher in the AKI group than in the non-AKI group.ConclusionThe incidence of AKI in critically ill patients was 3 9.4%.The independent risk factors for acute kidney injury included reoperation,postoperative APACHE II score,postoperative serum lactate,postoperative serum creatinine.Patients with AKI had poor prognosis,whose RRT,ICU mortality,hospital mortality,ICU hospital stay,total hospital stay,ICU total cost,and total hospitalization expenses were higher than those of non-AKI patients.