Vicente-Hernández B, Pérez-Beltrán CF, Rodríguez-Weber F, Díaz-Greene EJ

Language: Spanish
References: 0
Page: 151-158
PDF size: 137.02 Kb.

ABSTRACT

Background: Acute kidney injury (AKI) is a multifactorial acute dysfunction. In the postoperative period is associated with more morbidity and mortality and we have little information on AKI in noncardiac surgeries. Urine output (UO) is a functional index and a biomarker of tubular injury.
Objetive: To determine the incidence of AKI in patients post-appendectomy, the presence of postoperative oliguria and risk factors.
Material and Method: An observational, transversal, retrospective study was done. We reviewed records of patients undergoing appendectomy from February 2015 to January 2016 in the Hospital Ángeles Pedregal, Mexico City. We included patients aged 18 years and excluded patients without control of liquids. AKI was defined and classified by KDIGO guidelines. Demographics were expressed in medians. We used χ² Pearson as parametric measure and present data in OR with confidence interval (CI) 95%.
Results: In 12 months, 196 cases were reviewed. 114 patients did not meet fluid control and were excluded, left 82 patients for analysis. We found an AKI incidence of 26%, AKI I, 48% and AKI II, 52%. The median age in the AKI group was 38 years (18-77). From no-AKI group, 54% showed transient oliguria recovering transient oliguria and 21% at 4 hours. In the AKI group, 76% had oliguria in recovery (p=0.097, OR 2.54 95% CI 0.826-7.820); 81% had oliguria at 4 hours after surgery (p≤0.05, OR 95% CI 3.94-47.6 13.66), sensitivity and specificity of 80% and 79%, PPV 56% and NPV 92%.
Conclusion: We found a similar incidence reported in previous studies; however, we have more AKI II cases. We found a statistically significant association between UO 4 hours and AKI. AKI in the postoperative period has been associated with poor prognosis, so that timely detection for the proper handling is important. The presence of AKI in our population is considerable and strict control of fluids is essential for early detection, UO 4 hours after surgery can alert that patients may have AKI at 6 and 12 hours, starting an intervention.