Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study
Authors' conclusion
In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes.
Study context
- Population
- Patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or HDU admission)
- Participants
- 10,568 patients · 30 countries
- Exposure
- Postoperative acute kidney injury (PO-AKI) vs no PO-AKI
- PO-AKIn = 1,945
- Outcome
- Occurrence of PO-AKI defined by KDIGO criteria
- Follow-up
- Within 72 h of surgery
Methodological detailsinternational, multicentre, 30 countries
- International
- Multicentre
- 30 countries
Main finding
As reported in the abstract
PO-AKI incidence
PO-AKI
18.4%
1945
- KDIGO stage 1
- 63.5%
- KDIGO stage 2
- 25.7%
- KDIGO stage 3
- 10.7%
Observational data: associations, not effects.
Secondary outcomes
ICU mortality
Hospital mortality
Hospital LOS
- Renal replacement therapy (RRT) in ICU among patients with PO-AKI
- 8.7% · 170 of 1945
Persistent PO-AKI
- PO-AKI persistent
- 33.8%
ICU LOS
- Longer ICU LOS with PO-AKI; as printed: median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days
Risk factors for PO-AKI
- Older age, comorbidities (hypertension, DM, CKD), type, duration and urgency of surgery, intraoperative vasopressors and aminoglycosides
Original publication
Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study. Intensive Care Med. Published 28 July 2023. doi:10.
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