Pediatric anesthesia & critical care
Severe Preoperative Infection and Postoperative Acute Kidney Injury in Children: A Two-Hit Risk Factor for Mortality
Main finding · Postoperative AKIResult — go to the resultAdjusted relative risk 2.03 95% CI 1.51–2.74Authors' conclusion
Severe preoperative infection is associated with a higher risk of postoperative AKI and 30-day mortality after adjustment for measured confounders. The combination of preoperative infection and postoperative AKI produces a nine-fold higher risk of mortality
Study context
- Population
- Children younger than 18 years undergoing inpatient surgerypropensity score-matched
- Participants
- 144,718 participants
- Exposure
- Severe preoperative infection vs none
- Outcome
- Postoperative AKI (acute renal failure or progressive renal insufficiency)
- Follow-up
- 30 days
Methodological detailspropensity score-matched, NSQIP-Pediatric registry (2012-2023)
- Propensity score-matched
- NSQIP-Pediatric registry (2012-2023)
Main finding
Postoperative AKI
Adjusted relative risk
2.03
95% CI 1.51–2.74
P < 0.001
Severe preoperative infection vs No severe preoperative infection
aRR 2.03 (95% CI 1.51–2.74); P < 0.001
As reported in the abstract
- Postoperative acute kidney injury (AKI) overall
- 200 children (0.14%)
Observational data: associations, not effects.
Further findings
30-day mortality
| aRR (95% CI) | P value | ||
|---|---|---|---|
| Postoperative AKI4.6-times associated risk · propensity score-matched cohort · modified Poisson regression | 4.64 (3.48–6.12) | P < 0.001 | |
| Both conditionsOn an additive interaction scale · propensity score-matched cohort · modified Poisson regression | 9.63 (7.20–12.87) | P < 0.001 | |
| 0.050.21520Adjusted relative risk (log scale) |
| Outcome | aRR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortality · 30 daysPreoperative infection alone vs No severe preoperative infection · 1.8-times increase · propensity score-matched cohort · modified Poisson regression | 1.83 (1.60–2.10) | P < 0.001 | |
| 0.512Adjusted relative risk (log scale) |
Original publication
Severe Preoperative Infection and Postoperative Acute Kidney Injury in Children: A Two-Hit Risk Factor for Mortality. Anesth Analg. Published 27 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →