ABSTRACT
Objective:To identify the risk factors for acute kidney injury (AKI) after lumbar surgery in elderly patients and develop a score prediction model.Methods:The elderly patients who underwent lumbar surgery were retrospectively analyzed.The patients were divided into AKI group and non-AKI group according to the diagnostic criteria in Kidney Disease: Improving Global Outcomes.Demographic data, history of underlying diseases, perioperative general status and related research laboratory tests were collected.Factors with statistically significant differences between groups were included in the logistic regression model.Risk factors were identified and the weighted score regression prediction model was developed.The receiver operating characteristic curve was drawn, and the model was evaluated.Results:AKI occurred in 87 patients (11.9%) after operation.Logistic regression results showed that increasing age, hypertension, anemia, hypoproteinemia, diabetes mellitus, duration of intraoperative low mean arterial pressure and blood transfusion were independent risk factors for AKI in elderly patients after lumbar surgery.The area under the receiver operating characteristic curve and 95% confidence interval were 0.909 (0.870-0.947), the sensitivity was 79.36%, the specificity was 92.74%, and the Youdon index was 0.719.The line chart prediction model was developed.The prediction analysis model was verified by Hosmer-Lemshow test, P=0.413, and the C-index visualized line chart prediction model was 0.908. Conclusions:Increasing age, hypertension, hypoproteinemia, diabetes mellitus, anemia, duration of intraoperative low mean arterial pressure and blood transfusion are independent risk factors for AKI after lumbar surgery in elderly patients.The risk prediction model developed can effectively predict the occurrence of AKI after lumbar surgery in elderly patients.
ABSTRACT
Objective:To evaluate the relationship between declined preoperative left ventricular diastolic function and postoperative increased extravascular lung water (EVLW) in the patients undergoing transurethral resection of the prostate (TURP).Methods:A total of 116 patients, aged 55-90 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, with body mass index of ≤30 kg/m 2, undergoing elective TURP under general anesthesia, without increased EVLW before surgery, were included in the study.Lung ultrasound examination was performed and lung ultrasound scores were assessed before leaving PACU.Increased EVLW was defined as lung ultrasound score ≥20.The occurrence of increased EVLW after operation was recorded, and patients were divided into increased EVLW group and non-increased EVLW group according to whether increased EVLW occurred.Multivariate logistic regression analysis was used to identify the risk factors for postoperative increased EVLW. Results:The results of multivariate logistic regression analysis showed that declined preoperative left ventricular diastolic function was an independent risk factor for postoperative increased EVLW ( P<0.05). Conclusions:Declined preoperative left ventricular diastolic function is an independent risk factor for postoperative increased EVLW in the patients undergoing TURP.