title: Anesthetic technique and acute kidney injury in endovascular abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  Prior studies suggest that general anesthesia (GA) is associated with worse cardiopulmonary outcomes after endovascular abdominal aortic aneurysm repair (EVAR). Patients undergoing EVAR are at a high risk of developing perioperative acute kidney injury (AKI), and the relationship between anesthetic technique and AKI in these patients is not well-characterized. The authors sought to determine if anesthetic technique affected the risk of AKI in patients undergoing EVAR.
  
  
  METHODS
  Retrospective, observational cohort study analyzed using a multivariate logistic regression model to assess the effects of anesthetic technique on renal outcome.
  
  
  METHODS
  Multiple institutions, mainly in North America.
  
  
  METHODS
  Patients in the American College of Surgeons National Surgical Quality Improvement Program from 2005-2010 undergoing EVAR.
  
  
  METHODS
  The authors investigated the association between anesthetic techniques, comparing GA to alternative (non-GA) techniques, and AKI.
  
  
  RESULTS
  AKI was defined as an increase in the creatinine level of>2 mg/dL and/or dialysis. Of 13,026 patients, 84.4% underwent GA and 15.6% underwent non-GA techniques. AKI developed in 2.0% of the GA group and 1.4% of the non-GA group (unadjusted odds ratio [OR] 1.43, p = 0.075; adjusted OR [aOR] 1.00, p = 0.99). Risk factors for AKI include ASA class, ruptured aneurysm, preoperative renal dysfunction, symptomatic cardiovascular disease, and perioperative blood transfusion.
  
  
  CONCLUSIONS
  Anesthetic technique is not independently associated with the risk of AKI in patients undergoing EVAR.
authors: Department of Anesthesiology, Columbia University Medical Center, New York, NY. Electronic address: minjae.kim@columbia.edu.
authors: Minjae
authors: M
authors: Kim
authors: Department of Anesthesiology, Columbia University Medical Center, New York, NY; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
authors: Joanne E
authors: JE
authors: Brady
authors: Department of Anesthesiology, Columbia University Medical Center, New York, NY; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
authors: Guohua
authors: G
authors: Li
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects* / Q000379:methods*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: abdominal; acute kidney injury; anesthesia; aortic aneurysm; endovascular procedures; postoperative complications