Analysis of risk factors and prognosis of patients with acute kidney injury after lower limb fracture surgery
Objective To investigate the risk factors and prognosis of patients with acute kidney injury(AKI)after lower limb fracture surgery.Method The clinical data of 613 patients with lower limb fracture surgery admitted to Beijing Jishuitan Hospital,Capital Medical University from January to December 2016 were retrospectively analyzed.According to the occurrence of postoperative AKI,the subjects were divided into AKI group(postoperative AKI occured,36 cases)and non-AKI group(postoperative AKI not occured,577 cases).Univariate analysis and multivariate logistic regression analysis were used to investigate the independent influencing factors of postoperative AKI in patients with lower limb fracture.To analyze the prognosis of patients with AKI after lower limb fracture.Result Univariate analysis showed that the age,hip and thigh fracture ratio,intraoperative blood loss,length of hospital stay,urea nitrogen and serum creatinine of patients in AKI group were higher than those in non-AKI group,while the ratio of knee and calf fracture,ankle fracture ratio,hemoglobin,albumin,eGFR and prealbumin were lower than those in non-AKI group,and the differences were significant(P＜0.05).Multivariate logistic regression analysis showed that age≥61.0 years,intraoperative blood loss≥60.0 ml,length of hospital stay≥12.0 d,and serum creatinine≥79.0 μmol/L were independent risk factors for AKI in postoperative patients with lower limb fracture(P＜0.05).In this study,36 patients(5.87％)with lower extremity fracture developed postoperative AKI.Three patients in the AKI group received blood purification treatment,and two of them got rid of dialysis and were discharged successfully,but the postoperative follow-up one year found that their renal function did not recover to the preoperative baseline level.Another elderly(78 years)patient died after rescue.The remaining 33 patients did not receive blood purification treatment,and the renal function returned to the preoperative baseline level 2 to 3 weeks after surgery.Conclusion Elder,large amount of intraoperative blood loss,long hospital stay and high preoperative serum creatinine were independent risk factors for postoperative AKI in patients with lower limb fracture.
万方数据
维普
