The Perioperative Medicine Consult Handbook by Christopher J. Wong & Nason P. Hamlin

Author:Christopher J. Wong & Nason P. Hamlin
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

In evaluating patients with postoperative acute kidney injury (AKI) admitted to the ICU, similar risk factors were found, but ischemic and congestive heart disease, an elevated Revised Cardiac Risk Index score, and American Society for Anesthesiologists (ASA) physical status were identified as ­additional predictors [3].

A specific risk index for AKI after general surgery has subsequently been developed. The significant independent risk factors that were identified were age 56 or older, male gender, active congestive heart failure, ascites, hypertension, emergency surgery, intraperitoneal surgery, mild or moderate renal insufficiency (defined as preoperative creatinine between 1.2 and 1.9 or >2), and diabetes on oral or insulin therapy. Compared with 0–2 risk factors, having 3, 4, 5, 6, or more risk factors ­conferred a hazard ratio of AKI by 3.1, 8.5, 15.4, and 46.2, respectively [2].

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