Association of CD14 rs2569190 polymorphism with mortality in shock septic patients who underwent major cardiac or abdominal surgery: A retrospective study

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.

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Non-traumatic emergency abdominal surgery in nonagenarian patients: a retrospective study

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-021-01646-8 ◽

2021 ◽

Author(s):

Mattia Portinari ◽

Lara Bianchi ◽

Alessandro De Troia ◽

Giorgia Valpiani ◽

Savino Spadaro ◽

...

Keyword(s):

Retrospective Study ◽

Abdominal Surgery ◽

Emergency Abdominal Surgery

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Perioperative Use of Serum Creatinine and Postoperative Acute Kidney Injury: a Single Centre, Observational Retrospective Study to Explore Physicians’ Perception and Practice.

10.21203/rs.3.rs-146113/v1 ◽

2021 ◽

Author(s):

Gianluca Villa ◽

Silvia De Rosa ◽

Caterina Scirè Calabrisotto ◽

Alessandro Nerini ◽

Thomas Saitta ◽

...

Keyword(s):

Acute Kidney Injury ◽

Retrospective Study ◽

High Risk ◽

Abdominal Surgery ◽

Serum Creatinine ◽

Malignant Disease ◽

Kidney Injury ◽

Major Surgery ◽

Single Centre

Abstract Background. Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward use of serum creatinine (sCr) for identification of patients at risk for PO-AKI and patients who should be reassessed in the long-term for progression toward CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease.Methods. Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding use of sCr perioperatively and its relationship with PO-AKI.Results. A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long-term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high-risk for PO-AKI and LT-KDys.Conclusion. PO-AKI after major surgery for malignant disease is common but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients.Trial registration. Retrospectively registered in Clinicaltrialgov NCT04341974

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Perioperative Antibiotic Prophylaxis in Abdominal Surgery for Hernia Repair: Retrospective Study of 1,524 Consecutive Patients

Journal of Chemotherapy ◽

10.1179/joc.1998.10.3.248 ◽

1998 ◽

Vol 10 (3) ◽

pp. 248-253 ◽

Cited By ~ 6

Author(s):

E. Abo Rahmy

Keyword(s):

Retrospective Study ◽

Abdominal Surgery ◽

Hernia Repair ◽

Antibiotic Prophylaxis ◽

Perioperative Antibiotic Prophylaxis

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Retrospective study comparing continuous preperitoneal versus epidural local anesthetics infusion for abdominal surgery

European Journal of Anaesthesiology ◽

10.1097/00003643-201306001-00688 ◽

2013 ◽

Vol 30 ◽

pp. 220-220

Author(s):

Gil M. Polo ◽

O. Zugasti ◽

A. Pavon ◽

Bergara E. Perez ◽

E. Baldeon ◽

...

Keyword(s):

Retrospective Study ◽

Abdominal Surgery ◽

Local Anesthetics

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158Caudal epidural analgesia in pediatric infraumbilical abdominal surgery - safety and efficacy (a retrospective study of 9 years experience)

Regional Anesthesia and Pain Medicine ◽

10.1016/j.rapm.2006.06.120 ◽

2006 ◽

Vol 31 (5) ◽

pp. 58-58

Author(s):

N GAVRILOVA ◽

R ANDONOVA ◽

S KOTZEVA

Keyword(s):

Retrospective Study ◽

Abdominal Surgery ◽

Epidural Analgesia ◽

Safety And Efficacy

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The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

10.21203/rs.3.rs-16106/v2 ◽

2020 ◽

Author(s):

Soohyuk Yoon ◽

Seokha Yoo ◽

Min Hur ◽

Sun-Kyung Park ◽

Hyung-Chul Lee ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Retrospective Study ◽

Abdominal Surgery ◽

Bispectral Index ◽

Odds Ratio ◽

Postoperative Mortality ◽

Anesthetic Depth ◽

Cumulative Duration ◽

Cumulative Time

Abstract Background The influence of intraoperative low bispectral index (BIS) values and hypotension on poor clinical outcomes has been controversial. The purpose of this study was to investigate the influence of intraoperative low BIS values and hypotension on postoperative mortality in patients undergoing major abdominal surgery. Methods This retrospective study analyzed 1,862 cases of general anesthesia. We collected the cumulative time of BIS values below 20 and 40 as well as electroencephalographic suppression and documented the incidences in which these states were maintained for at least 5 minutes. Durations of intraoperative mean arterial pressures (MAP) less than 50 mmHg were also recorded. Multivariable logistic regression was used to evaluate the association between suspected risk factors and postoperative mortality. Results Ninety-day mortality and 180-day mortality were 1.5% and 3.2% respectively. The cumulative time in minutes for BIS values falling below 40 coupled with MAP falling below 50 mmHg was associated with 90-day mortality (odds ratio, 1.26; 95% confidence interval, 1.04-1.53; P = .019). We found no association between BIS related values and 180-day mortality. Conclusions Delicate adjustment of anesthetic depth is important to avoid excessive brain suppression and hypotension, which could be associated with postoperative mortality.

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