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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/3/541 |
| _version_ | 1797610732029739008 |
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| author | Yongzhong Tang Bo Li Wen Ouyang Guiping Jiang Hongjia Tang Xing Liu |
| author_facet | Yongzhong Tang Bo Li Wen Ouyang Guiping Jiang Hongjia Tang Xing Liu |
| author_sort | Yongzhong Tang |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-11T06:19:22Z |
| format | Article |
| id | doaj.art-962d5ccdab9d42b4b22cd01c05407407 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T06:19:22Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-962d5ccdab9d42b4b22cd01c054074072023-11-17T12:03:48ZengMDPI AGJournal of Personalized Medicine2075-44262023-03-0113354110.3390/jpm13030541Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic SurgeryYongzhong Tang0Bo Li1Wen Ouyang2Guiping Jiang3Hongjia Tang4Xing Liu5Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaOperation Center, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaDepartment of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaDepartment of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaDepartment of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaDepartment of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaBackground: 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.https://www.mdpi.com/2075-4426/13/3/541intraoperative hypertensionacute kidney injurylaparoscopic surgerymean arterial pressureexposure time |
| spellingShingle | Yongzhong Tang Bo Li Wen Ouyang Guiping Jiang Hongjia Tang Xing Liu Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery Journal of Personalized Medicine intraoperative hypertension acute kidney injury laparoscopic surgery mean arterial pressure exposure time |
| 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 | intraoperative hypertension acute kidney injury laparoscopic surgery mean arterial pressure exposure time |
| url | https://www.mdpi.com/2075-4426/13/3/541 |
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