Insuffisance Rénale Aigue Post-Opératoire Au Centre Hospitalier Universitaire Et Départemental Du Borgou : Fréquence Et Facteurs De Risques Associés

Introduction: Acute renal failure (ARF) post-operative is a specific form of acute deficiencies causing multiple declining factors. Objective: This survey aims to study the incidence and risk factors associated with acute renal failure (ARF) in post-operative surgical intensive care units to University Hospital of Borgou (UH-B): during 2015. Patients and Methods this study is a cross sectional, descriptive and analytical ones with the prospective data collection from March 1st to August 31th, 2015. The research has involved all patients admitted to the operating room for surgery and motherhood whatever reason and then transferred respectively to the intensive care areas at UH-B. The postoperative ARF has been investigated inner patients following inclusion criteria and classification according to RIFLE score. The socio-demographic, clinical and biological variables monitoring, even support and evolution are experimented. A questionnaire is designed for data collection. Data are analyzed by Epi-Info means with 5% of significance level. Results: 130 patients are registered. The mean age is 27.68 ± 12.87 years. The sex ratio is 0.66. The frequency of post-operative ARF reaches 12.31%. The associated risk factors are: hypertension (p = 0.0018), diabetes (p = 0.002), heart failure (p = 0.0104), severe sepsis (p = 0.006) hypovolemic shock (p = 0.002), ASA class ≥ 3 (p = 0.0014), preeclampsia-eclampsia (p = 0.012), the Altémier class classification ≥ 3 (p = 0.0164), a pathological urinary sediment like a proteinuria (p=0.006), haematuria (p= 0.001) and nitrituria (p=0.007). Consequently, three (03) subjects out of sixteen (16) have died (18.75%). Conclusion: The post-operative ARF is a reality in University Hospital Borgou , with a higher mortality rate. Thus, the prevention strategy is the best treatment through the screening and monitoring promotion towards risk factors.

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Risk factors for death among critically ill patients with acute renal failure

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000500004 ◽

2006 ◽

Vol 124 (5) ◽

pp. 257-263 ◽

Cited By ~ 15

Author(s):

Geraldo Bezerra da Silva Júnior ◽

Elizabeth De Francesco Daher ◽

Rosa Maria Salani Mota ◽

Francisco Albano Menezes

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Mechanical Ventilation ◽

Renal Failure ◽

Acute Renal Failure ◽

Intensive Care ◽

Liver Failure ◽

Critically Ill ◽

Critically Ill Patients ◽

Urine Volume

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.

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The Change in Renal Replacement Therapy on Acute Renal Failure in a General Intensive Care Unit in a University Hospital and its Clinical Efficacy: A Japanese Experience

Therapeutic Apheresis and Dialysis ◽

10.1046/j.1526-0968.2003.00094.x ◽

2003 ◽

Vol 7 (5) ◽

pp. 475-482 ◽

Cited By ~ 14

Author(s):

Yoh Hirayama ◽

Hiroyuki Hirasawa ◽

Shigeto Oda ◽

Hidetoshi Shiga ◽

Kazuya Nakanishi ◽

...

Keyword(s):

Intensive Care Unit ◽

Renal Failure ◽

Acute Renal Failure ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Clinical Efficacy ◽

University Hospital ◽

General Intensive Care Unit ◽

Japanese Experience

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MO344INCIDENCE AND RISK FACTORS FOR ACUTE POSTOPERATIVE RENAL FAILURE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab084.0017 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Imane Failal ◽

Sanae Ezzaki ◽

Rania Elafifi ◽

Mohamed Zamd ◽

Naoufal Mtioui ◽

...

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Acute Renal Failure ◽

Hypovolemic Shock ◽

Perioperative Period ◽

Male Predominance ◽

Associated Risk Factors ◽

Postoperative Aki ◽

Acute Failure ◽

Postoperative Renal Failure

Abstract Background and Aims Postoperative acute renal failure (AKI) is a particular form of acute failure with several triggers. Decreased renal blood flow and the resulting ischemia seem to be the most common cause of kidney damage. The objective was to study the incidence and risk factors associated with post-operative AKI. Method It was a retrospective, descriptive study spanning a 3-year period from January 1, 2017 to December 31, 2019. The patients in this series were admitted to the various surgical departments. Results Our study included 618 cases of AKI. The incidence of postoperative AKI was 8.73%. The average age of our patients was 40.4 +/- 12.3 years, a male predominance with a sex ratio of 1.2. The main history was diabetes found in 39%, hypertension in 27.5% and an injection of contrast product a few days before the intervention in 14.5%. General surgery topped the list in 49.5% of our patients, followed by trauma in 25%, gyneco-obstetrics in 14.5%, and 11% for the rest of the surgeries. The associated risk factors were: hypovolemic shock, diabetes, severe sepsis. Conclusion The occurrence of acute renal failure in the postoperative period results from factors related to the field and surgery. Hence the need for early identification of risk situations, in order to reduce the incidence of renal damage during the perioperative period.

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Epidemiological profile of postoperative digestive fistulas

JOURNAL OF SURGICAL AND CLINICAL RESEARCH ◽

10.20398/jscr.v12i2.25642 ◽

2021 ◽

Vol 12 (2) ◽

pp. 77-88

Author(s):

Bianca Marochi ◽

Daniela Thaís Lorenzi Pereira ◽

Luiza Manfroi Lattmann ◽

Sthefany Mais ◽

Arthur Nathan Luiz Ferreira Matos ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Surgical Procedures ◽

Length Of Hospital Stay ◽

Cross Sectional Study ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Cross Sectional ◽

Urgent Surgery ◽

Epidemiological Profile

Background and objectives: Gastrointestinal fistulas are anomalous communications between the digestive system and other structures. This article presents the epidemiological profile of patients who developed postoperative abdominal fistulas and their outcomes. Methods: Cross-sectional study that evaluated surgical procedures done in a 25 week period that presented risks for fistulous formations. Were analyzed age, type of the surgery (elective or urgent), pre-existing risk factors, need for post-surgical intensive care unit, type of fistula, reoperations to the fistula treatment, and outcome (discharge or death). Results: There were 1785 abdominal surgical procedures, with a fistula incidence of 1.8%. Most of the patients who developed fistulas were over 60 years old (71.4%), and surgeries that resulted in fistulous complications were mainly urgent (75.0%), with the need for intensive care in 46.9%. The most frequent types of fistula were enteral (52.3%) and biliary (23.8%), and surgical treatment took place in 53.1% of cases. Late hospital discharge was predominant in these patients (40.6%), and the death rate was 3.1%. Discussion: These complications are common after abdominal surgery and require clinical attention. There is a correlation between the formation of the fistulas and urgent surgery procedures, directly impacting the length of hospital stay. Conclusion: The risk factors of fistula development are advanced age and the presence of malignant disease. They are more prevalent in urgent surgeries and patients were more likely to need reoperation and have a delay on discharge.

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THE FREQUENCY AND OUTCOME OF ACUTE RENAL FAILURE IN PATIENTS IN SURGICAL INTENSIVE CARE UNITS

Critical Care Medicine ◽

10.1097/00003246-199401000-00142 ◽

1994 ◽

Vol 22 (1) ◽

pp. A77 ◽

Cited By ~ 1

Author(s):

Edmund Rutherford ◽

Robert Rutledge ◽

Samir M. Fakhry ◽

Roxie Albrecht ◽

Rosemary O??Meeghan ◽

...

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Intensive Care ◽

Intensive Care Units ◽

Surgical Intensive Care

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The Impact of Mild Renal Dysfunction on Postoperative Mortality in the Surgical Intensive Care Unit

The American Surgeon ◽

10.1177/000313480707300802 ◽

2007 ◽

Vol 73 (8) ◽

pp. 743-747

Author(s):

Mary-Margaret Brandt ◽

Anthony Falvo ◽

H. Mathilda Horst

Keyword(s):

Intensive Care Unit ◽

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Intensive Care ◽

Renal Dysfunction ◽

Postoperative Mortality ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

The Impact

The negative impact of mild to moderate renal dysfunction on patient outcome is often underestimated. Any amount of renal dysfunction is deleterious in the surgical intensive care unit (SICU). We evaluated all surgery patients admitted to our SICU. We identified two groups of patients: no renal failure and acute renal failure. A total of 5152 patients were included in this study. There were 1259 patients in the acute renal failure group. The average number of ventilator days increased by 2.2 for every increase of creatinine by 1.0. Patients who required dialysis stayed an average of 11 days longer than patients who did not have any renal failure. For every increase of creatinine by 1.0, average cost increased by $23,048. Only 7 per cent of the patients with acute renal failure required dialysis (n = 85). The odds ratio for mortality compared with those patients without renal failure was 7.06 (confidence interval, 3.91–12.76) regardless of the definition of renal failure. This study demonstrates that even mild to moderate renal failure increases mortality. Moreover, we demonstrated that even a mild decline in renal function increases length of stay, ventilator days, and cost in patients in the SICU. Aggressive vigilance in the prevention of any loss of renal function is warranted in the SICU.

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