The incidence and risk factors of acute kidney injury after surgery for oromaxillofacial head and neck tumor

doi:10.19438/j.cjoms.2023.04.011

Abstract

Abstract: PURPOSE: To determine the incidence and risk factors of acute kidney injury (AKI) in patients undergoing surgery for oromaxillofacial head and neck tumors. METHODS: Patients undergoing surgery for oromaxillofacial head and neck cancer from January 2014 to December 2021 at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine were collected and retrospectively analyzed. AKI was defined an absolute increase in plasma creatinine of 26.5 μmol/L within 48 h or a 1.5 times increase in creatinine within 7 days according to the Kidney Disease Improving Global Outcomes(KDIGO) criteria. Two groups were divided according to whether AKI occurred after surgery: AKI group and non-AKI group. The incidence of postoperative AKI was calculated, and the rates of postoperative mechanical ventilation, mortality, ICU stay, length of hospital stay and hospital costs were compared between the two groups. Logistic regression analysis was performed to identify independent risk factors for AKI with SPSS 26.0 software package. RESULTS: A total of 6 830 patients (mean age 59.3 years, 4 238 men and 2 592 women) were included. Postoperative AKI was observed in 134(2.0%) patients, with stage 1, 2 and 3 AKI in 129, 4 and 1, respectively. Multivariate logistic analysis revealed that female (OR=2.166, 95%CI: 1.440-3.259), non-steroidal anti-inflammatory drugs(NSAIDs) (OR=2.305, 95%CI: 1.088-4.883), anemia(OR=1.688, 95%CI: 1.132-2.517), albuminuria(OR=2.080, 95%CI: 1.242-3.482) and prolonged anesthesia (OR=0.346, 95%CI: 0.196-0.612) were independently associated with the development of AKI. Patients in the AKI group had a higher mortality rate(1.0%) during hospitalization, but AKI did not impact clinical outcomes. CONCLUSIONS: Postoperative AKI occurred in 2.0% of patients after oromaxillofacial head and neck tumor surgery. Female, NSAIDs, anemia, albuminuria and long-term anesthesia were independent risk factors for postoperative AKI.

Key words: Oromaxillofacial head and neck tumor, Acute kidney injury, Risk factors, KDIGO criteria

CLC Number:

R730.6

LI Ping, LUO Tao, HUANG Can, ZHOU Chi, SUN Yu. The incidence and risk factors of acute kidney injury after surgery for oromaxillofacial head and neck tumor[J]. China Journal of Oral and Maxillofacial Surgery, 2023, 21(4): 384-389.

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