Epidemiology of postoperative acute kidney injury in Hungarian intensive care units: an exploratory analysis.
BACKGROUND
The aim of this study was to evaluate the incidence and outcome of postoperative acute kidney injury (AKI) after major noncardiac surgery in Hungarian intensive care units (ICUs).


METHODS
We conducted an analysis of a multicenter survey on the epidemiology of AKI in Hungarian ICUs in respect of surgical interventions. The cohort study consisted of all patients (n = 295) over the age of 18 years who were admitted to ICUs after surgery between 1 October 2009 and 30 November 2009. AKI was defined and classified by the acute kidney injury network (AKIN) criteria.


RESULTS
Forty-eight (18.1%) patients had AKI during their ICU stay. By AKIN criteria, 27 (10.2%) patients were in stage 1, 11 (4.2%) patients in stage 2, and 10 (3.8%) patients in stage 3. The overall mortality rate of AKI was 39.6% (AKI 1: 25.9%, AKI 2: 40%, and AKI 3: 54.5%; p < 0.001) and the ICU mortality rate was 33.3% (AKI 1: 18.5%, AKI 2: 10%, and AKI 3: 54.5%; p < 0.001). According to logistic regression analysis, age (OR: 1.048; CI: 1.014-1.082; p = 0.005), vasopressor treatment (OR: 9.751; CI: 8.579-10.923; p < 0.001), sepsis (OR: 10.791; CI: 9.353-12.233; p = 0.001), serum-creatinine peak-concentration (OR: 1.035; CI: 1.021-1.047; p < 0.001), and intra-abdominal surgery (OR: 2.558; CI: 1.75-3.366; p = 0.020) were independent predictors for AKI.


CONCLUSIONS
The results of this study confirm that there is a high incidence of AKI following major noncardiac surgery, which is associated with higher ICU and in-hospital mortality.
Department of Anesthesiology and Intensive Care Medicine, Dr. Kenessey Albert Hospital, Balassagyarmat, Hungary. dr.medve.laszlo@chello.hu
Laszlo
L
Medve
Tibor
T
Gondos
D000005:Abdomen / Q000601:surgery*; D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000368:Aged; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors