Perioperative medicine & outcomes
Heart failure diagnostic accuracy, intraoperative fluid management, and postoperative acute kidney injury: a single-centre prospective observational study
An erratum to this article was published (Br J Anaesth, Sep 2025 ↗)
Main finding · Intraoperative fluid administrationResult — go to the resultDifference 470 ml 95% CI 120–830Authors' conclusion
An accurate preoperative diagnosis of heart failure before noncardiac surgery is associated with reduced intraoperative fluid administration and less acute kidney injury.
Study context
- Population
- Adults undergoing major noncardiac surgery at an academic hospital, 2015 to 2019from 40,659 surgeries
- Participants
- 1,018 adults
- Exposure
- True positives vs False negatives
- Outcome
- Volume of intraoperative fluid administered
Methodological detailssingle-centre, adjudicated reference standard by multispecialty physician panel, stratified subsample, False negatives more commonly had preserved left ventricular ejection fractions and fewer comorbidities
- Single-centre
- Adjudicated reference standard by multispecialty physician panel
- Stratified subsample
- False negatives more commonly had preserved left ventricular ejection fractions and fewer comorbidities
Main finding
Intraoperative fluid administration
Difference
470 ml
95% CI 120–830
P = 0.009
True positives vs False negatives
difference 470 ml (95% CI 120–830); P = 0.009
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | |
|---|---|---|
| Postoperative AKI | 0.39 (0.18–0.89) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Fluids and acute kidney injury (AKI) in patients without adjudicated heart failure (HF) (subgroup)
- Non-HF not associated with differences in either fluids administered or AKI
Original publication
Heart failure diagnostic accuracy, intraoperative fluid management, and postoperative acute kidney injury: a single-centre prospective observational study. Br J Anaesth. Published 10 October 2024. doi:10.
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