Incidence, Risk Factors and Consequences of Acute Kidney Injury in Patients Undergoing Esophageal Cancer Surgery

Study Overview
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Brief Summary
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Esophagectomy serves as an exemplar of major operative trauma, with well-known risk of pulmonary, cardiac, anastomotic, and septic complications and the presence of postoperative complications after esophagectomies for cancer is associated with a reduced long-term survival. There is a paucity in the literature regarding postoperative renal outcomes after esophageal surgery, with a wide range of incidence. The investigators will conduct a historical cohort study aiming to evaluate the incidence of postoperative acute kidney injury in patients undergoing elective esophageal cancer surgery. Secondary, the investigators will assess the progression of the acute injury and the association with adverse pulmonary, cardiac, anastomotic, and septic events, as well as increase in hospital stay and mortality. The investigators will also identify risk factors associated with acute kidney injury occurrence.

Official Title
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Incidence, Risk Factors and Consequences of Acute Kidney Injury in Patients Undergoing Esophageal Cancer Surgery: a Historical Cohort Study

Conditions
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Acute Kidney Injury, Postoperative Complications

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective esophagectomy Exclusion Criteria: End-stage renal disease Missing data for acute kidney injury definition Second surgery (for patients having multiple surgeries performed during a 30-day period, only the first in each period will be included)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| esophageal cancer surgery<br>patients undergoing elective esophageal surgery for cancer | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postoperative acute kidney injury | according to KDIGO criteria | within 48 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of transient or persistent postoperative acute kidney injury | according KDIGO criteria | 48 hours after development of acute kidney injury | 
| Number of patients with renal recovery | according ADQI criteria | at 7 days, after 30 days and 3 months | 
| Incidence of postoperative pulmonary complications | based on European Perioperative Clinical Outcome (EPCO) definitions | within 30 days after surgery | 
| Incidence of major adverse cardiac and cerebrovascular events (MACCE) | composite outcome of non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, new cardiac arrhythmia, angina, ischemic stroke | within 30 days after surgery | 
| Incidence of sepsis | according Sepsis-3 definition | within 30 days after surgery | 
| Mortality in hospital | any death during the admission when the operation was performed | 1 year | 
| Increase in length of hospital stay | compared to the expected length of hospital stay according ACS NSQIP calculation | 1 year |