1. Incidence, risk factors and prognosis of changes in serum creatinine early after aortic abdominal surgery
- Author
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Christoph Ellenberger, Nicolas Paul Henri Murith, Aristotelis Panos, John Diaper, Afksendiyos Kalangos, Alexandre Schweizer, Gregory Katchatourian, and Marc Licker
- Subjects
Male ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Renal function ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Acute Kidney Injury/blood/epidemiology/prevention & control ,chemistry.chemical_compound ,Switzerland/epidemiology ,Postoperative Complications ,Risk Factors ,Intensive care ,Internal medicine ,medicine ,Humans ,Aortic Aneurysm, Abdominal/surgery ,Prospective Studies ,Biological Markers/blood ,Risk factor ,skin and connective tissue diseases ,Prospective cohort study ,Aged ,Creatinine ,ddc:617 ,business.industry ,Incidence ,Postoperative Complications/blood/epidemiology/prevention & control ,Creatinine/blood ,Acute Kidney Injury ,Prognosis ,medicine.disease ,Surgery ,Logistic Models ,ROC Curve ,chemistry ,Multivariate Analysis ,Female ,sense organs ,business ,Biomarkers ,Switzerland ,Aortic Aneurysm, Abdominal ,Kidney disease ,Abdominal surgery - Abstract
Objective: To determine the incidence, risk factors, and prognostic implications of serum creatinine changes following major vascular surgery. Design: Observational study. Settings: University hospital. Patients: Cohort of 599 consecutive patients undergoing elective abdominal aortic surgery. Interventions: Review of prospectively collected data from 1993 to 2004. Measurements and results: The receiver-operator characteristic (ROC) curve analysis was used to detect the best threshold for postoperative elevation in serum creatinine (Δ Creat) in relation to major complications. Acut-off value of +0.5 mg/dl was selected to define renal dysfunction (RD0.5 group, n = 91; no RD0.5, n = 508) that was associated with higher mortality (7.7% in RD0.5 group vs 1.4% in no RD0.5 group, P 40 min; OR, 3.8, 95% CI, 1.9-7.2), blood transfusion (> 5 units; OR, 1.9, 95% CI 1.2-6.1), and rhabdomyolysis (OR, 3.6, 95% CI 1.7-7.9). Conclusions: Postoperative RD0.5 (Δ Creat > 0.5 mg/dl) occurs in 15% of vascular patients and carries abad prognosis. Preoperative renal insufficiency and factors related to the complexity of surgery are the main predictors of renal dysfunction
- Published
- 2006