Postoperative renal function evaluation, through RIFLE criteria, of elderly patients who underwent femur fracture surgery under spinal anesthesia.
BACKGROUND
The postoperative acute renal failure (ARF) incidence in different kinds of surgery has rarely been studied. Age, cardiac dysfunction, previous renal dysfunction, intraoperative hypoperfusion, and use of nephrotoxic medications are mentioned as risk factors for ARF at the postoperative period. The postoperative ARF definition was based on the creatinine increase by the RIFLE classification (R = risk, I = injury, F = failure, L = loss, E = end stage), which corresponds to a 1.5 creatinine increase, two to three times, respectively, above the basal value. This study aimed to evaluate the postoperative ARF incidence in elderly patients who underwent femur fracture surgery under subarachnoid anesthesia and stratify it by the RIFLE criteria.


METHODS
Ninety patients older than 65 years under spinal anesthesia with fixed dosage of 15 mg of 0.5% isobaric bupivacaine associated with morphine 50 mug were studied. Immediate postoperative creatinine was considered basal and compared with maximal creatinine evaluated at 24, 48, and 72 postoperative hours.


RESULTS
The mean age of the patients was 80.27 years. ARF incidence was 24.44% and stratified this way: R = 21.11% and I = 3.33%.


CONCLUSIONS
In conclusion, the postoperative ARF incidence after femur fracture surgery in patients over 65 years was 24.44%. By analyzing the stratification based on the RIFLE classification, the incidence was categorized as Risk (R) = 21.11% and Injury (I) = 3.33%.
Azevedo
Vera Lucia Fernandes
VL
Botucatu Medical School, UNESP - Sao Paulo State University, SP, Brazil.
Silveira
Marco Antonio Santos
MA
Santos
Jedson Nascimento
JN
Braz
José Reinaldo Cerqueira
JR
Braz
Leandro Gobbo
LG
Módolo
Norma Sueli Pinheiro
NS
D058186:Acute Kidney Injury / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal; D003404:Creatinine / Q000097:blood*; D005264:Femoral Fractures / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications; D011184:Postoperative Period
D003404:Creatinine