Early postoperative hypoalbuminemia is a risk factor for postoperative acute kidney injury following hip fracture surgery
Early postoperative hypoalbuminemia is a risk factor for postoperative acute kidney injury following hip fracture surgery
复制标题
DOI：
10.1016/j.injury.2018.05.001
复制
发表时间：
2018-08-01
影响因子：
2.5
通讯作者：
Han, Seung-Beom
中科院分区：
文献类型：
--
作者：
Shin, Kyun-Ho;Han, Seung-Beom
引言：急性肾损伤（阿基）是老年人髋部骨折手术后常见的严重并发症。低白蛋白血症是阿基的已知独立风险因素。然而，很少有研究调查髋部骨折术后早期低白蛋白血症与阿基之间的关系。因此，我们试图确定阿基的发病率和危险因素，以及髋关节骨折术后早期低白蛋白血症对阿基发病率的影响，尤其是股骨近端转子间骨折。在这项单中心回顾性队列研究中，我们回顾了481例连续的（>60岁）股骨近端转子间骨折手术患者的病历。进行多元逻辑回归以确定阿基的独立风险因素。在确定术后前两天的术后血清白蛋白最低水平的临界值后，我们将患者分为两组：第1组包括251例术后早期最低血清白蛋白水平≥ 2.9 g/dL的患者。阿基的发病率进行了分析，使用治疗加权的逆概率（IPTW），倾向评分匹配（PSM），和倾向评分匹配加权（PSMW）analysis.Results：阿基的发病率，根据肾脏疾病改善全球结局标准定义，为11.8%（n = 57）。慢性肾脏病与术后早期最低血清白蛋白水平
Introduction: Acute kidney injury (AKI) is a common and serious complication after hip fracture surgery in older adults. Hypoalbuminemia is a known independent risk factor for AKI. However, few studies have investigated the relationship between early postoperative hypoalbuminemia and AKI after hip fracture surgery. Therefore, we sought to determine the incidence of and risk factors for AKI and the effects of early postoperative hypoalbuminemia on AKI incidence after surgery for hip fractures, especially intertrochanteric fractures of the proximal femur.Patients and methods: In this retrospective cohort study from a single center, we reviewed the medical records of 481 consecutive patients (>60 years) who underwent surgery for intertrochanteric fracture of the proximal femur. Multiple logistic regression was performed to identify independent risk factors for AKI. After determining the cut-off value of the minimal level of postoperative serum albumin during the first two postoperative days, we divided the patients into two groups: group 1 included 251 patients whose minimal early postoperative serum albumin level was = 2.9 g/dL. The incidence of AKI was analyzed using inverse probability of treatment weighting (IPTW), propensity score matching (PSM), and propensity score matching weighting (PSMW) analyses.Results: The incidence of AKI, defined based on the Kidney Disease Improving Global Outcomes criteria, was 11.8% (n = 57). Chronic kidney disease and the minimal early postoperative serum albumin level