OBJECTIVE: To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery. DESIGN: Prospective clinical observational study. SETTING: Surgical intensive care unit in a university hospital. PATIENTS: Two hundred and fifteen consecutive adult patients operated on for infra-renal abdominal aortic surgery during 1 year. INTERVENTIONS: A moderate increase in plasma creatinine of 20% from preoperative value (renal dysfunction, RD) was systematically recorded during the first 3 days following surgery. Organ dysfunctions (cardiac, pulmonary, haematological, and neurological) were assessed. MEASUREMENTS AND RESULTS: Forty-three patients (20%) experienced a postoperative RD; six of these required dialysis. RD was associated with other organ dysfunctions in 60.5% patients. Mortality rate was significantly higher for patients who had a RD, than patients without RD (9.3% vs 1.2%, P<0.02). Mean ICU stay of patients with RD was significantly longer (7.9+/-5.6 days vs 5.0+/-1.8 days, P<0.01). However, patients with RD but without other organ dysfunctions had a mortality rate of 0% and did not have a significantly longer stay in ICU than patients without any organ dysfunctions (5.2+/-2.1 days vs 4.6+/-1.2 days, P=0.09). CONCLUSION: Our results suggest that a postoperative 20%-increase in plasma creatinine after abdominal aortic surgery is not rare and occurs frequently with other organ dysfunction.
OBJECTIVE: To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery. DESIGN: Prospective clinical observational study. SETTING: Surgical intensive care unit in a university hospital. PATIENTS: Two hundred and fifteen consecutive adult patients operated on for infra-renal abdominal aortic surgery during 1 year. INTERVENTIONS: A moderate increase in plasma creatinine of 20% from preoperative value (renal dysfunction, RD) was systematically recorded during the first 3 days following surgery. Organ dysfunctions (cardiac, pulmonary, haematological, and neurological) were assessed. MEASUREMENTS AND RESULTS: Forty-three patients (20%) experienced a postoperative RD; six of these required dialysis. RD was associated with other organ dysfunctions in 60.5% patients. Mortality rate was significantly higher for patients who had a RD, than patients without RD (9.3% vs 1.2%, P<0.02). Mean ICU stay of patients with RD was significantly longer (7.9+/-5.6 days vs 5.0+/-1.8 days, P<0.01). However, patients with RD but without other organ dysfunctions had a mortality rate of 0% and did not have a significantly longer stay in ICU than patients without any organ dysfunctions (5.2+/-2.1 days vs 4.6+/-1.2 days, P=0.09). CONCLUSION: Our results suggest that a postoperative 20%-increase in plasma creatinine after abdominal aortic surgery is not rare and occurs frequently with other organ dysfunction.
Authors: Christoph Ellenberger; Alexandre Schweizer; John Diaper; Afksendiyos Kalangos; Nicolas Murith; Gregory Katchatourian; Aristote Panos; Marc Licker Journal: Intensive Care Med Date: 2006-08-08 Impact factor: 17.440
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