Abstract: FR-PO118
AKI in the Surgical Ward: A Single-Center Study
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Kushnir, Daniel, Carmel Medical Center, Haifa, Haifa, Israel
- Tanasiychuk, Tatiana, Carmel Medical Center, Haifa, Haifa, Israel
- Kayali, Jawad, Carmel Medical Center, Haifa, Haifa, Israel
- Frajewicki, Victor, Carmel Medical Center, Haifa, Haifa, Israel
Background
Acute Kidney Injury (AKI) is a non-uncommon condition with unknown incidence, mostly it take place in hospitalized patients and it is often under recognized. AKI significantly affects short and long-term morbidity and mortality.
Methods
A retrospective single center cohort study was performed, using the electronic medical records (EMR) of the hospital. AKI was defined as an increase of serum creatinine level of at least of 0.5 mg/dl from the previous test. We identified patients with AKI during the period January 1st –December 31, 2019, hospitalized in our hospital in the non-cardiac surgical clinics during this period. Chronic dialysis patients were excluded from the analysis.
Results
The final analysis included 203 patients hospitalized in Surgical Wards. Median age of patients was 75 (20-97), while 62% were men, almost 50% were diabetics, showing a mean Charlson score of 6. Almost 50% had CKD before the hospitalization with a median eGFR 61 ml/min. Seventy seven percent of patients were operated during the hospitalization. Most (66%) of operations were non elective. In 9% cases renal replacement therapy (RRT) was performed. All of them underwent non-elective operations. Patients needing RRT were younger, with lower hemoglobin, more frequent use of nephrotoxic antibiotics, received intravascular contrast, were mechanically ventilated and hypotensive, with sepsis. All-cause 90-day mortality was 33%. All-cause 90-day mortality was higher in cases of non-elective operations, in patients with hemoglobin level less than 8 mg/dl, higher American Society of Anaesthesiologists score, and hypotension during the hospitalization. Mortality rate was lower in diabetic patients (p=0.009). Management of AKI: only 47% of patients had urinalysis, renal imaging was done in 15%, monitoring of urine output was performed in 76%. Only in one third of cases there was any addressing to AKI in the EMR, and only in 43% of AKI was a main diagnosis at discharge.
Conclusion
It seems that non-diabetic, severely anemic (hemoglobin less than 8 mg/dl) patients with high ASA Score are at higher risk to AKI. More efforts should be done to recognize high risk patients with aim to prevent AKI, and improve renal failure management in the surgical departments.