{"id":7351,"date":"2022-05-17T20:47:00","date_gmt":"2022-05-17T20:47:00","guid":{"rendered":"https:\/\/bostonsp.com\/?p=7351"},"modified":"2023-09-08T18:33:29","modified_gmt":"2023-09-08T18:33:29","slug":"intraoperative-hypotension-is-associated-with-persistent-acute-kidney-disease-after-noncardiac-surgery-a-multicentre-cohort-study","status":"publish","type":"post","link":"https:\/\/bostonsp.com\/index.php\/2022\/05\/17\/intraoperative-hypotension-is-associated-with-persistent-acute-kidney-disease-after-noncardiac-surgery-a-multicentre-cohort-study\/","title":{"rendered":"Intraoperative hypotension is associated with persistent acute kidney disease after noncardiac surgery: a multicentre cohort study"},"content":{"rendered":"

Shaw, A. D., Khanna, A. K., Smischney, N. J., Shenoy, A. V., Boero, I. J., Bershad, M., Hwang, S., Chen, Q., & Stapelfeldt, W. H. (2022). Intraoperative hypotension is associated with persistent acute kidney disease after noncardiac surgery: a multicentre cohort study.\u00a0British Journal of Anaesthesia<\/i>,\u00a0129<\/i>(1), 13\u201321. https:\/\/doi.org\/10.1016\/j.bja.2022.03.027<\/a><\/p>\n

View article<\/a><\/strong><\/p>\n\n\n

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Abstract<\/h4>\n

Background:<\/strong> Whilst intraoperative hypotension is associated with postoperative acute kidney injury (AKI), the link between intraoperative hypotension and acute kidney disease (AKD), defined as continuing renal dysfunction for up to 3 months after exposure, has not yet been studied.<\/p>\n

Methods:<\/strong> We conducted a retrospective multicentre cohort study using data from noncardiac, non-obstetric surgery extracted from a US electronic health records database. Primary outcome was the association between intraoperative hypotension, at three MAP thresholds (\u226475, \u226465, and \u226455 mm Hg), and the following two AKD subtypes: (i) persistent (initial AKI incidence within 7 days of surgery, with continuation between 8 and 90 days post-surgery) and (ii) delayed (renal impairment without AKI within 7 days, with AKI occurring between 8 and 90 days post-surgery). Secondary outcomes included healthcare resource utilisation for patients with either AKD subtype or no AKD.<\/p>\n

Results:<\/strong> A total of 112 912 surgeries qualified for the study. We observed a rate of 2.2% for delayed AKD and 0.6% for persistent AKD. Intraoperative hypotension was significantly associated with persistent AKD at MAP \u226455 mm Hg (hazard ratio 1.1; 95% confidence interval: 1.38\u20131.22; P<0.004). However, IOH was not significantly associated with delayed AKD across any of the MAP thresholds. Patients with delayed or persistent AKD had higher healthcare resource utilisation across both hospital and intensive care admissions, compared with patients with no AKD.<\/p>\n

Conclusions:<\/strong> Intraoperative hypotension is associated with persistent but not delayed acute kidney disease. Both types of acute kidney disease appear to be associated with increased healthcare utilisation. Correction of intraoperative hypotension is a potential opportunity to decrease postoperative kidney injury and associated costs.<\/p>","protected":false},"excerpt":{"rendered":"

Shaw, A. D., Khanna, A. K., Smischney, N. J., Shenoy, A. V., Boero, I. J., Bershad, M., Hwang, S., Chen, Q., & Stapelfeldt, W. H. (2022). Intraoperative hypotension is associated with persistent acute kidney disease after noncardiac surgery: a multicentre cohort study.\u00a0British Journal of Anaesthesia,\u00a0129(1), 13\u201321. https:\/\/doi.org\/10.1016\/j.bja.2022.03.027<\/a> View article Abstract Background: Whilst intraoperative hypotension is […]<\/p>\n","protected":false},"author":7,"featured_media":7355,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_eb_attr":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[9],"tags":[179,157,184,108,180,181,182,183,143,99,133],"class_list":["post-7351","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publications","tag-acute-kidney-disease","tag-acute-kidney-injury","tag-effect-on-persistent-delayed-acute-kidney-disease","tag-electronic-health-records","tag-healthcare-resource-utilization","tag-intraoperative-hypotension","tag-mean-arterial-pressure","tag-noncardiac-surgery","tag-optum-database","tag-real-world-evidence","tag-retrospective"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t