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Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery

Background: It is well demonstrated that intraoperative blood pressure is associated with postoperative acute kidney injury (AKI); however, the association between severity and duration of abnormal intraoperative blood pressure (BP) with AKI in patients undergoing laparoscopic surgery remains unknow...

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Autores principales: Tang, Yongzhong, Li, Bo, Ouyang, Wen, Jiang, Guiping, Tang, Hongjia, Liu, Xing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058414/
https://www.ncbi.nlm.nih.gov/pubmed/36983722
http://dx.doi.org/10.3390/jpm13030541
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author Tang, Yongzhong
Li, Bo
Ouyang, Wen
Jiang, Guiping
Tang, Hongjia
Liu, Xing
author_facet Tang, Yongzhong
Li, Bo
Ouyang, Wen
Jiang, Guiping
Tang, Hongjia
Liu, Xing
author_sort Tang, Yongzhong
collection PubMed
description Background: It is well demonstrated that intraoperative blood pressure is associated with postoperative acute kidney injury (AKI); however, the association between severity and duration of abnormal intraoperative blood pressure (BP) with AKI in patients undergoing laparoscopic surgery remains unknown. Methods: This retrospective cohort study included 12,414 patients aged ≥ 18 years who underwent a single elective laparoscopic abdominal surgery during hospitalization between October 2011 and April 2017. Multivariate stepwise logistic regressions were applied to determine the correlation between the severity and duration of intraoperative mean arterial pressure (MAP, (systolic BP + 2 × diastolic BP)/3), acute intraoperative hypertension (IOTH) and postoperative AKI, in different periods of surgery. Results: A total of 482 hospitalized patients (3.9%) developed surgery-related AKI. Compared with those without IOTH or with preoperative mean MAP (80–85 mmHg), acute elevated IOTH (odds ratio, OR, 1.4, 95% CI, 1.1 to 1.7), mean MAP 95–100 mmHg (OR, 1.8; 95% CI, 1.3 to 2.7), MAP 100–105 mmHg (OR, 2.4; 95% CI, 1.6 to 3.8), and more than 105 mmHg (OR, 1.9; 95% CI, 1.1 to 3.3) were independent of other risk factors in a diverse cohort undergoing laparoscopic surgery. In addition, the risk of postoperative AKI appeared to result from long exposure (≥20 min) to IOTH (OR, 1.9; 95% CI, 1.5 to 2.5) and MAP ≥ 115 mmHg (OR, 2.2; 95% CI, 1.6 to 3.0). Intraoperative hypotension was not found to be associated with AKI in laparoscopic surgery patients. Conclusions: Postoperative AKI correlates positively with intraoperative hypertension in patients undergoing laparoscopic surgery. These findings provide an intraoperative evaluation criterion to predict the occurrence of postoperative AKI.
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spelling pubmed-100584142023-03-30 Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery Tang, Yongzhong Li, Bo Ouyang, Wen Jiang, Guiping Tang, Hongjia Liu, Xing J Pers Med Article Background: It is well demonstrated that intraoperative blood pressure is associated with postoperative acute kidney injury (AKI); however, the association between severity and duration of abnormal intraoperative blood pressure (BP) with AKI in patients undergoing laparoscopic surgery remains unknown. Methods: This retrospective cohort study included 12,414 patients aged ≥ 18 years who underwent a single elective laparoscopic abdominal surgery during hospitalization between October 2011 and April 2017. Multivariate stepwise logistic regressions were applied to determine the correlation between the severity and duration of intraoperative mean arterial pressure (MAP, (systolic BP + 2 × diastolic BP)/3), acute intraoperative hypertension (IOTH) and postoperative AKI, in different periods of surgery. Results: A total of 482 hospitalized patients (3.9%) developed surgery-related AKI. Compared with those without IOTH or with preoperative mean MAP (80–85 mmHg), acute elevated IOTH (odds ratio, OR, 1.4, 95% CI, 1.1 to 1.7), mean MAP 95–100 mmHg (OR, 1.8; 95% CI, 1.3 to 2.7), MAP 100–105 mmHg (OR, 2.4; 95% CI, 1.6 to 3.8), and more than 105 mmHg (OR, 1.9; 95% CI, 1.1 to 3.3) were independent of other risk factors in a diverse cohort undergoing laparoscopic surgery. In addition, the risk of postoperative AKI appeared to result from long exposure (≥20 min) to IOTH (OR, 1.9; 95% CI, 1.5 to 2.5) and MAP ≥ 115 mmHg (OR, 2.2; 95% CI, 1.6 to 3.0). Intraoperative hypotension was not found to be associated with AKI in laparoscopic surgery patients. Conclusions: Postoperative AKI correlates positively with intraoperative hypertension in patients undergoing laparoscopic surgery. These findings provide an intraoperative evaluation criterion to predict the occurrence of postoperative AKI. MDPI 2023-03-17 /pmc/articles/PMC10058414/ /pubmed/36983722 http://dx.doi.org/10.3390/jpm13030541 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tang, Yongzhong
Li, Bo
Ouyang, Wen
Jiang, Guiping
Tang, Hongjia
Liu, Xing
Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery
title Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery
title_full Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery
title_fullStr Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery
title_full_unstemmed Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery
title_short Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery
title_sort intraoperative hypertension is associated with postoperative acute kidney injury after laparoscopic surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058414/
https://www.ncbi.nlm.nih.gov/pubmed/36983722
http://dx.doi.org/10.3390/jpm13030541
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