Intraoperative hypotension is associated with acute kidney injury in noncardiac surgery: An observational study
Intraoperative hypotension is associated with acute kidney injury in noncardiac surgery: An observational study
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DOI：
10.1097/eja.0000000000000735
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发表时间：
2018-04-01
影响因子：
3.6
通讯作者：
Bell, Max
中科院分区：
文献类型：
--
作者：
Hallqvist, Linn;Granath, Fredrik;Bell, Max
背景围手术期急性肾损伤（阿基）是常见的，并增加发病率和死亡率的风险。注意事项为了确定术中低血压（定义为从基线的个体降低）与围手术期阿基风险之间的关联。背景观察性队列研究。瑞典斯德哥尔摩卡罗林斯卡大学医院，从2012年10月至2013年5月和2015年10月至2016年4月。患者所有接受重大择期非心脏手术并计划在术后病房过夜的成年患者均纳入本研究。排除接受嗜铬细胞瘤手术的患者。数据收集术前危险因素（合并症），术中事件（低血压定义为SBP相对于每个患者的基线降低超过40%或50%，并且持续超过5分钟）和术后数据从医疗记录中收集。127例（27%）患者在围手术期发生阿基。阿基与男性[（66 vs. 48%）P40%，70 vs. 57%，P=0.013; > 50%，20 vs. 12%，P=0.024）和失血量更多（800 vs. 400 ml，P
BACKGROUNDPerioperative acute kidney injury (AKI) is common and increases the risk of morbidity and mortality.OBJECTIVESTo determine the association between intraoperative hypotension, defined as an individual decrease from baseline and the risk of perioperative AKI.DESIGNObservational cohort study.SETTINGKarolinska University Hospital, Stockholm, Sweden, from October 2012 to May 2013 and October 2015 and April 2016.PATIENTSAll adult patients undergoing major elective noncardiac surgery who were scheduled for an overnight admission in the postoperative unit were included. Patients undergoing phaeochromocytoma surgery were excluded.DATA COLLECTIONPreoperative risk factors (comorbidities), intraoperative events (hypotension defined as a more than 40 or 50% decrease in SBP relative to each patient's baseline and lasting more than 5min) and postoperative data were collected from medical records.MAIN OUTCOME MEASURESAKI within the first two postoperative days.RESULTSOf the final cohort of 470 patients, 127 (27%) developed AKI in the perioperative period. AKI was associated with male sex [(66 vs. 48%) P40%, 70 vs. 57%, P=0.013; >50%, 20 vs. 12%, P=0.024) and greater blood loss (800 vs. 400ml, P