A nomogram for predicting acute kidney injury following hepatectomy: A propensity score matching analysis

Liting Kuang; Weibin Lin; Bin Chen; Dahui Wang; Qingliang Zeng

doi:10.1016/j.jclinane.2023.111211

A nomogram for predicting acute kidney injury following hepatectomy: A propensity score matching analysis

J Clin Anesth. 2023 Nov:90:111211. doi: 10.1016/j.jclinane.2023.111211. Epub 2023 Jul 20.

Authors

Liting Kuang¹, Weibin Lin², Bin Chen³, Dahui Wang¹, Qingliang Zeng⁴

Affiliations

¹ Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
² Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China. Electronic address: linwb6@mail.sysu.edu.cn.
³ Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
⁴ Internet Hospital Office, Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.

PMID: 37480714
DOI: 10.1016/j.jclinane.2023.111211

Abstract

Study objective: The low central venous pressure (LCVP) technique is a key technique in hepatectomy, but its impact on acute kidney injury (AKI) is unclear. The purpose of this study was to explore risk factors (in particular LCVP time) for AKI following hepatectomy.

Design: A retrospective case-control study with propensity score matching.

Setting: Operating room.

Patients: A total of 1949 patients who underwent hepatectomy were studied.

Interventions: The patients were grouped with or without AKI within 7 days after surgery. Univariable and multivariable analyses were performed, including recognized intraoperative predictors. The final result is represented as a nomogram.

Measurements: Preoperative, intraoperative and postoperative data were collected. LCVP is monitored directly through a central venous catheter via the right internal jugular vein.

Main results: AKI occurred in 148 patients (7.59%). Surgery time, minimum SBP, furosemide administration and norepinephrine were identified as independent risk factors. The area under the curve for the receiver operating characteristic curves was 0.726 (95% CI 0.668-0.783).

Conclusion: Intraoperative parameters can be used to predict the probability of postoperative AKI. Although AKI increases the length of stay, it may not increase in-hospital mortality. LCVP time was not confirmed to be a risk factor for AKI.

Keywords: Acute kidney injury; Hepatectomy; Logistic regression; Low central venous pressure; Prediction model.

MeSH terms

Acute Kidney Injury* / diagnosis
Acute Kidney Injury* / epidemiology
Acute Kidney Injury* / etiology
Case-Control Studies
Hepatectomy* / adverse effects
Humans
Nomograms
Propensity Score
Retrospective Studies