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. 2022 Apr 12:9:779754.
doi: 10.3389/fmed.2022.779754. eCollection 2022.

Acute Kidney Injury and 3-Year Mortality in Elderly Patients After Non-cardiac Surgery

Qiong-Fang Wu  1 , Mao-Wei Xing  1 , Wen-Jun Hu  2 , Xian Su  1 , Dan-Feng Zhang  3 , Dong-Liang Mu  1 , Dong-Xin Wang  1
Affiliations

Acute Kidney Injury and 3-Year Mortality in Elderly Patients After Non-cardiac Surgery

Qiong-Fang Wu et al. Front Med (Lausanne). .

Abstract

Objective: The present study aimed to investigate whether acute kidney injury (AKI) was associated with 3-year mortality in elderly patients after non-cardiac surgery.

Methods: The present study was a 3-year follow-up study of two randomized controlled trials. A total of 1,319 elderly patients who received non-cardiac surgery under general anesthesia were screened. AKI was diagnosed by the elevation of serum creatinine within a 7-day postoperative period according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. A long-term telephonic follow-up was undertaken by investigators who were not involved in the previous two trials and had no access to the study group assignment. The date of death was taken from the official medical death certificate. The primary outcome was to investigate the association between AKI and postoperative 3-year mortality using the multivariable Cox regression risk model.

Results: Of the 1,297 elderly patients (mean age 71.8 ± 7.2 years old) who were included in the study, the incidence of AKI was 15.5% (201/1297). Of the patients with AKI, 85% (170/201) were at stage 1, 10% (20/201) at stage 2, and 5% (11/201) at stage 3. The 3-year all-cause mortality was 28.9% (58/201) in patients with AKI and 24.0% (263/1,096) in patients without AKI (hazard ratio 1.247, 95% confidence interval 0.939-1.657, P = 0.128). The multivariable Cox regression showed that AKI was not associated with 3-year mortality after adjustment of confounding factors (adjusted hazard ratio 1.045, 95% confidence interval 0.780-1.401, P = 0.766).

Conclusions: AKI was a common postoperative complication, but it was not associated with 3-year mortality in elderly patients who underwent non-cardiac surgery. The low incidence of severe AKI might underestimate its underlying association with long-term mortality.

Keywords: 3-year; acute kidney injury; non-cardiac surgery; survival; the elderly.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A flowchart of the study. AKI, acute kidney injury.
Figure 2
Figure 2
The Kaplan-Meier analysis of 3-year mortality between two groups. Cumulative 3-year mortality was comparable between two groups (Log-rank test P = 0.13). AKI, Acute kidney injury.
See this image and copyright information in PMC

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