Frequency of Postoperative Acute Kidney Injury and its Related Risk Factors in Patients Undergoing Major Orthopedic Surgery in Rasht, Iran

A. Ashraf, P. Aghajanzadeh, Niloofar Hamedi, M. Akbarpour
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Abstract

Background: Patients who undergo major orthopedic surgery are at risk of acute kidney injury (AKI) due to blood loss, electrolyte disorders, infection, and other co-morbidities. In this study, we aim to investigate the frequency of AKI and its risk factors in patients undergoing major orthopedic surgery in Rasht, Iran. Objective: This is an analytical cross-sectional study on 180 patients undergoing major orthopedic surgery. Those with a history of chronic kidney disease and dialysis were excluded. Methods: The data including patients’ age, gender, drug history, history of underlying diseases, duration of surgery, mean arterial pressure during and after surgery, and use of inotrope during and after surgery, and creatinine level before and after the surgery. Results: The mean age of patients was 47.3±22.8 years. The incidence of AKI was 11.11%. The use of some drugs, duration of surgery, MAP, and inotrope use had no significant relationship. The occurrence of AKI had a significant relationship with the history of heart disease, diabetes, and kidney disease. Multiple linear regression analysis results showed that with the increase of one unit in preoperative creatinine level, the postoperative creatinine level increased by 0.3. Conclusion: The incidence of AKI after major orthopedic surgery in Rasht city is relatively high. Careful monitoring of kidney function before, during, and after major orthopedic surgery is important; it can prevent the occurrence of postoperative AKI.
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伊朗Rasht骨科大手术患者术后急性肾损伤发生率及其相关危险因素
背景:由于失血、电解质紊乱、感染和其他合并症,接受重大骨科手术的患者存在急性肾损伤(AKI)的风险。在这项研究中,我们的目的是调查在伊朗拉什特接受重大骨科手术的患者AKI的频率及其危险因素。目的:对180例骨科大手术患者进行横断面分析研究。排除有慢性肾脏疾病和透析史的患者。方法:收集患者年龄、性别、用药史、基础疾病史、手术时间、术中及术后平均动脉压、术中及术后肌酐水平、肌酐使用情况等资料。结果:患者平均年龄47.3±22.8岁。AKI发生率为11.11%。某些药物的使用、手术时间、MAP与肌力的使用无显著关系。AKI的发生与心脏病、糖尿病、肾病史有显著关系。多元线性回归分析结果显示,术前肌酐水平每增加1单位,术后肌酐水平增加0.3。结论:拉什特市骨科大手术后AKI发生率较高。在重大骨科手术之前、期间和之后仔细监测肾功能是很重要的;可以预防术后AKI的发生。
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