• Minjae Kim, Ravi P Kiran, and Guohua Li.
• Department of Anesthesiology, Columbia University Medical Center, 622 West 168th Street, PH 5, Suite 505C, New York, NY 10032, USA.
• J Hepatobiliary Pancreat Sci. 2019 Apr 1; 26 (4): 144-153.

BackgroundHepatectomy presents unique challenges potentially heightening acute kidney injury (AKI) risk, but the full spectrum of risk factors has not been identified.MethodsData for hepatectomy patients in the 2016 American College of Surgeons National Surgical Quality Improvement Program (n = 3,814) was randomly split into derivation (70%) and validation (30%) cohorts. AKI was defined as an increase in serum creatinine ≥0.3 mg/dl or ≥1.5-fold above the preoperative value within 30 days of surgery. Multivariable logistic regression assessed preoperative and intraoperative risk factors for AKI.ResultsOf 2,692 patients (derivation cohort), 432 (16%) developed AKI. Risk factors were the following: age (years; adjusted odds ratio [aOR] 1.016 [95% confidence interval 1.006-1.026], female sex (aOR 0.65 [0.51-0.82]), body mass index (kg/m2 ; aOR 1.043 [1.024-1.062]), diabetes (aOR 1.71 [1.31-2.24]), hypertension (aOR 1.66 [1.30-2.13]), hematocrit (%; aOR 0.944 [0.924-0.966]), operative time (min; aOR 1.004 [1.003-1.004]), planned open procedure (aOR 2.00 [1.47-2.73]), and Pringle maneuver (aOR 1.36 [1.07-1.72]). The areas under the curve of the receiver operating characteristic curves were 0.74 (95% CI 0.71-0.76) and 0.71 (95% CI 0.67-0.75) in the derivation and validation cohorts, respectively.ConclusionsPostoperative AKI affects one in six hepatectomy patients; preoperative and intraoperative factors can predict the risk of postoperative AKI.© 2019 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

8 keywords...

hide…