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dc.contributor.authorLong, Thorir E
dc.contributor.authorHelgason, Dadi
dc.contributor.authorHelgadottir, Solveig
dc.contributor.authorPalsson, Runolfur
dc.contributor.authorGudbjartsson, Tomas
dc.contributor.authorSigurdsson, Gisli H
dc.contributor.authorIndridason, Olafur S
dc.contributor.authorSigurdsson, Martin I
dc.date.accessioned2016-06-30T09:48:48Z
dc.date.available2016-06-30T09:48:48Z
dc.date.issued2016-06
dc.date.submitted2016
dc.identifier.citationAcute Kidney Injury After Abdominal Surgery: Incidence, Risk Factors, and Outcome. 2016, 122 (6):1912-20 Anesth. Analg.en
dc.identifier.issn1526-7598
dc.identifier.pmid27195635
dc.identifier.doi10.1213/ANE.0000000000001323
dc.identifier.urihttp://hdl.handle.net/2336/615134
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.abstractAcute kidney injury (AKI) is a serious complication after major surgical procedures. We examined the incidence, risk factors, and mortality of patients who sustained AKI after abdominal surgery in a large population-based cohort.
dc.description.abstractAll patients who underwent open and laparoscopic abdominal surgery (excluding genitourinary and abdominal vascular procedures), between 2007 and 2014 at the University Hospital in Reykjavik were identified and their perioperative serum creatinine (SCr) measurements used to identify AKI after surgery employing the Kidney Disease: Improving Global Outcome (KDIGO) criteria. Risk factors were evaluated using multivariate logistic regression analysis and 30-day mortality compared with a propensity score-matched control group.
dc.description.abstractDuring the 8-year period, a total of 11,552 abdominal surgeries were performed on 10,022 patients. Both pre- and postoperative SCr measurements were available for 3902 (33.8%) of the surgical cases. Of these, 264 (6.8%) were complicated by AKI; 172 (4.4%), 49 (1.3%), and 43 (1.1%) were classified as KDIGO stages 1, 2 and 3, respectively. The overall incidence of AKI for patients with available SCr values was 67.7 (99% confidence interval [CI], 57.7-78.6) per 1000 surgeries. In logistic regression analysis, independent risk factors for AKI were female sex (odds ratio [OR] = 0.68; 99% CI, 0.47-0.98), hypertension (OR = 1.75; 99% CI, 1.10-2.74), preoperative chronic kidney disease (OR= 1.68; 99% CI, 1.12-2.50), ASA physical status classification of IV (OR = 9.48; 99% CI, 3.66-29.2) or V (OR = 21.4; 99% CI, 5.28-93.6), and reoperation (OR = 4.30; 99% CI, 2.36-7.70). Patients with AKI had greater 30-day mortality (18.2% vs 5.3%; P < 0.001) compared with propensity score-matched controls.
dc.description.abstractAKI is an important complication of abdominal surgery. In addition to sex, hypertension, and chronic kidney disease, ASA physical status classification is an independent predictor of AKI. Individuals who develop AKI have substantially worse short-term outcomes, including higher 30-day mortality, even after correcting for multiple patient- and procedure-related risk factors.
dc.description.sponsorshipLandspitali University Hospital Research Fund/A-2014-030en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://dx.doi.org/ 10.1213/ANE.0000000000001323en
dc.relation.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=&AN=00000539-201606000-00030&PDF=yen
dc.rightsArchived with thanks to Anesthesia and analgesiaen
dc.subjectNýruen
dc.subjectSkurðlæknaren
dc.subjectNEP12
dc.subjectTAS12
dc.subjectAAA12
dc.subject.meshAcute Kidney Injury/mortalityen
dc.subject.meshIncidenceen
dc.subject.meshRisk Factorsen
dc.subject.meshHospital Mortalityen
dc.subject.meshPostoperative Complications/epidemiologyen
dc.subject.meshPostoperative Complications/mortalityen
dc.subject.meshIcelanden
dc.titleAcute Kidney Injury After Abdominal Surgery: Incidence, Risk Factors, and Outcome.en
dc.typeArticleen
dc.contributor.department[ 1 ] Landspitali, Natl Univ Hosp Iceland, Internal Med, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 2 ] Landspitali, Surg, Natl Univ Hosp Iceland, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 3 ] Landspitali, Perioperat Serv, Natl Univ Hosp Iceland, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 4 ] Univ Iceland, Fac Med, Reykjavik, Iceland [ 5 ] Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, 75 Francis St, Boston, MA 02115 USAen
dc.identifier.journalAnesthesia and analgesiaen
dc.rights.accessLandspitali Access - LSH-aðganguren
html.description.abstractAcute kidney injury (AKI) is a serious complication after major surgical procedures. We examined the incidence, risk factors, and mortality of patients who sustained AKI after abdominal surgery in a large population-based cohort.
html.description.abstractAll patients who underwent open and laparoscopic abdominal surgery (excluding genitourinary and abdominal vascular procedures), between 2007 and 2014 at the University Hospital in Reykjavik were identified and their perioperative serum creatinine (SCr) measurements used to identify AKI after surgery employing the Kidney Disease: Improving Global Outcome (KDIGO) criteria. Risk factors were evaluated using multivariate logistic regression analysis and 30-day mortality compared with a propensity score-matched control group.
html.description.abstractDuring the 8-year period, a total of 11,552 abdominal surgeries were performed on 10,022 patients. Both pre- and postoperative SCr measurements were available for 3902 (33.8%) of the surgical cases. Of these, 264 (6.8%) were complicated by AKI; 172 (4.4%), 49 (1.3%), and 43 (1.1%) were classified as KDIGO stages 1, 2 and 3, respectively. The overall incidence of AKI for patients with available SCr values was 67.7 (99% confidence interval [CI], 57.7-78.6) per 1000 surgeries. In logistic regression analysis, independent risk factors for AKI were female sex (odds ratio [OR] = 0.68; 99% CI, 0.47-0.98), hypertension (OR = 1.75; 99% CI, 1.10-2.74), preoperative chronic kidney disease (OR= 1.68; 99% CI, 1.12-2.50), ASA physical status classification of IV (OR = 9.48; 99% CI, 3.66-29.2) or V (OR = 21.4; 99% CI, 5.28-93.6), and reoperation (OR = 4.30; 99% CI, 2.36-7.70). Patients with AKI had greater 30-day mortality (18.2% vs 5.3%; P < 0.001) compared with propensity score-matched controls.
html.description.abstractAKI is an important complication of abdominal surgery. In addition to sex, hypertension, and chronic kidney disease, ASA physical status classification is an independent predictor of AKI. Individuals who develop AKI have substantially worse short-term outcomes, including higher 30-day mortality, even after correcting for multiple patient- and procedure-related risk factors.


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