Perioperative medicine & outcomes
Candidate Kidney Protective Strategies for Patients Undergoing Major Abdominal Surgery: A Secondary Analysis of the RELIEF Trial Cohort
Authors' conclusion
Avoiding intraoperative nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors is a potential strategy to mitigate the risk for postoperative AKI.
Study context
- Population
- Adults undergoing major abdominal surgery randomised to a restrictive or liberal perioperative fluid regimenanalysed
- Participants
- 2,444 adults
- Comparison
- Modifiable risk factors associated with greater maximum stage of postoperative acute kidney injury (AKI)
- Primary endpoint
- Maximum AKI stage
- Follow-up
- Before hospital discharge
Methodological detailsmultivariable ordinal regression, two modelling approaches (investigator-informed and Least Absolute Shrinkage and Selection Operator (LASSO))
- Multivariable ordinal regression
- Two modelling approaches (investigator-informed and LASSO)
Primary result
As reported in the abstract
Maximum AKI stage (single-group incidence)
- Stage 1 AKI
- 223 (9.1%)
- Stage 2 AKI
- 59 (2.4%)
- Stage 3 AKI
- 36 (1.5%)
- Intraoperative-only NSAID or COX-2 inhibitor: increased odds of greater maximum AKI stage (model 1), OR
- 1.77 (1.11 to 2.82) (99% CI)
- Day-of-surgery ACE inhibitor or ARB vs no regular use: increased odds of greater maximum AKI stage (model 1), OR
- 1.84 (1.15 to 2.94) (99% CI)
Further findings
Nadir haemoglobin on POD 1 (model 2) · postoperative day 1
- Inverse association between nadir haemoglobin on POD 1 and greater maximum AKI stage
Original publication
Candidate Kidney Protective Strategies for Patients Undergoing Major Abdominal Surgery: A Secondary Analysis of the RELIEF Trial Cohort. Anesthesiology. Published 21 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →