The relationship between trajectories of renal oxygen saturation and acute kidney injury: a prospective cohort study with a secondary analysis
Abstract
Background Acute kidney injury (AKI) is a major postoperative consequence, affecting prognosis of older patients. Effective prediction or intervention to predict or prevent the incidence of AKI is currently unavailable. Aims Dynamic changes of renal tissue oxygen saturation (RSO_2) during surgery process are understudied and we intended to explore the distinct trajectories and associations with postoperative AKI. Methods This was a secondary analysis including data for older patients who underwent open hepatectomy surgery with informed consent. Latent class mixed models (LCMM) method was conducted to generate trajectories of intraoperative renal tissue RSO_2 through different time points. The primary outcome was postoperative 7-day AKI. The univariate and multivariate regression analysis were performed to identify the relationship between distinct trajectories of renal tissue RSO_2 and the risk of AKI. Meanwhile, the prediction efficacy of renal tissue RSO_2 at different time points was compared to find potential intervention timing. Results Postoperative AKI occurred in 14 (15.2%) of 92 patients. There are two distinct renal tissue RSO_2 trajectories, with 44.6% generating "high-downwards" trajectory and 55.4% generating "consistently-high" trajectory. Patients with "high-downwards" trajectory had significantly higher risk of postoperative AKI than another group (Unadjusted OR [Odds Ratio] = 3.790, 95% CI [Confidence Interval]: 1.091–13.164, p = 0.036; Adjusted OR = 3.973,…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 92 participants or records.
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