YẾU TỐ NGUY CƠ LIÊN QUAN ĐẾN TỔN THƯƠNG THẬN CẤP SAU PHẪU THUẬT TẠI BỆNH VIỆN HỮU NGHỊ ĐA KHOA NGHỆ AN

Abstract

Objectives: to recognize the risk factors for acute kidney injury after surgery at Nghe An General Hospital. Subjects and methods: An analysis observational study on 138 patients treated at Department of Surgical Intensive Care, Nghe An General Hospital from April 2023 to March 2024. Results: Risk factors for postoperative AKI included many underlying diseases (OR = 2.3), gastrointestinal surgery (OR = 2.5), thoracic surgery (OR = 3.1), shock before or during surgery (OR = 5.0 and 2.9), amount of fluid given to the patient before surgery, p < 0.05. SOFA and APACHE II scores on admission in the group requiring continuous hemodialysis were higher than those in the group without dialysis. Preoperative and intraoperative fluid infusion in the group requiring continuous dialysis were 1.3 ± 0.3 (liters) and 1.8 ± 0.4 (liters), respectively, significantly higher than those in the group without dialysis, with p < 0.05. The rate of shock before and during surgery was also a risk factor for increasing the rate of continuous dialysis in patients with AKI after surgery. High SOFA score and low urine output were two main risk factors for postoperative AKI when conducting multivariate regression testing. Conclusion: Underlying diseases, thoracic and gastrointestinal surgery, and large amounts of positive-balance fluids during surgery were risk factors for postoperative AKI. SOFA, APACHE II scores, and positive-balance fluid volume before and during surgery were predictors for post-operative AKI patients requiring extracorporeal dialysis.