Incidence, risk factors and outcomes of postoperative acute kidney injury in elderly patients undergoing abdominal surgery

Abstract Objectives To investigate the incidence, risk factors and outcomes of acute kidney injury (AKI) in elderly patients undergoing abdominal surgery. Methods A retrospective study exploring the incidence of AKI in patients older than 75 years within 48 hours after abdominal surgery was conducted. Patients' preoperative characteristics, intraoperative management including medication and outcomes were evaluated for associations with AKI using a logistic regression model.Results During the 2.5-year period, a total of 409 abdominal surgeries were performed. Both pre- and post-operative SCr measurements were available for 329 (80.4%) cases. 26 patients (7.9%) developed AKI, of whom 25 (7.6%) and 1 (0.3%) reached the AKI stages 1 and 2 respectively. Older age (83.0 vs 80.4 years; p=0.002), preoperative liver function damage represented by AST (47.5 vs 21.0 IU/L; p=0.023), intraoperative combined administration of hydroxyethyl starch(HES) and furosemide (15.38% vs 1.65%; p=0.003) were independent risk factors for the development of postoperative AKI. Furthermore, AKI patients had significantly longer ICU stay (3 vs 0 days; p<0.001) and higher in-hospital mortality (23.08% vs 2.31%; p<0.001)Conclusion Intraoperative combined administration of HES and furosemide is an independent factor which can be controlled by anesthesiologists and surgeons for AKI. This provides important recommendations for reducing the incidence of postoperative AKI.