Incidence and circumstances of serum creatinine increase after abdominal aortic surgery.
OBJECTIVE
To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery.


METHODS
Prospective clinical observational study.


METHODS
Surgical intensive care unit in a university hospital.


METHODS
Two hundred and fifteen consecutive adult patients operated on for infra-renal abdominal aortic surgery during 1 year.


METHODS
A moderate increase in plasma creatinine of 20% from preoperative value (renal dysfunction, RD) was systematically recorded during the first 3 days following surgery. Organ dysfunctions (cardiac, pulmonary, haematological, and neurological) were assessed.


RESULTS
Forty-three patients (20%) experienced a postoperative RD; six of these required dialysis. RD was associated with other organ dysfunctions in 60.5% patients. Mortality rate was significantly higher for patients who had a RD, than patients without RD (9.3% vs 1.2%, P<0.02). Mean ICU stay of patients with RD was significantly longer (7.9+/-5.6 days vs 5.0+/-1.8 days, P<0.01). However, patients with RD but without other organ dysfunctions had a mortality rate of 0% and did not have a significantly longer stay in ICU than patients without any organ dysfunctions (5.2+/-2.1 days vs 4.6+/-1.2 days, P=0.09).


CONCLUSIONS
Our results suggest that a postoperative 20%-increase in plasma creatinine after abdominal aortic surgery is not rare and occurs frequently with other organ dysfunction.
Ryckwaert
Frédérique
F
Department of Anesthesiology and Intensive Care, Hopital Arnaud de Villeneuve, avenue du Doyen Giraud, 34295 Montpellier, France. f-ryckwaert@chu-montpellier.fr
Alric
Pierre
P
Picot
Marie-Christine
MC
Djoufelkit
Kela
K
Colson
Pascal
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery*; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D003404:Creatinine