Clinical trial NCT04041323: Incidence and Outcomes of Acute Kidney Injury in Postoperative ICU Patients - a Retrospective Data Analysis
Official title: Incidence and Outcomes of Acute Kidney Injury in Postoperative ICU Patients - a Retrospective Data Analysis
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Kidney Injury
ICU
Postoperative Patients
Keywords: AKI
KDIGO
ICU
postoperative
Lead sponsor: Medical University of Vienna
Sponsor class: OTHER
First posted: 2019-08-01
Enrollment: 5000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: retrospective data analysis of postoperative ICU patients admitted to anaesthesiological and surgical ICUs of the General Hospital Vienna, Austria between January 1, 2016 and December 31, 2018.

Brief summary: Acute kidney injury (AKI) is a common complication in critically ill patients. Based on the sensitive KDIGO criteria, the incidence of AKI on ICU varies between 30-60 %. These large variations of incidence of AKI are due to different baseline characteristics of studied patients, the length of observation period, use of creatinine criteria only or use of creatinine and urine output criteria. Furthermore, back estimation of baseline creatinine instead of measured creatinine in patients with missing laboratory values may lead to overestimation of AKI severity and outcomes. Major surgery, trauma, infection, sepsis or a complication of severe illness can lead to an abrupt decrease in glomerular filtration in critically ill patients. Such episode of AKI is associated with short term adverse effects such as fluid overload, electrolyte imbalance, acid-base derangements, immune dysfunction, coagulation abnormalities and alterations in mental status. Additionally, AKI in critically ill patients leads to prolonged ICU length of stay, increase in morbidity and mortality as well as higher costs. Multiple large studies found, after correction for potential confounders, that AKI was independently associated with worse outcomes. Moderate and severe AKI stages were associated with 2.9 - 6.9 fold increased in-hospital mortality (3). Increasing AKI severity in ICU patients was not only associated with increased mortality, AKI patients had also worse renal function at the time of hospital discharge. The individual condition leading to AKI in combination with increased susceptibility to AKI may significantly influence outcome. Indeed, current data from many studies show that mortality from AKI differs in various clinical settings.

However, there are not enough data on different types of surgery and their effect on AKI yet. The aim of our epidemiological study is to investigate the occurrence and outcomes of AKI in different types of surgery in postoperative ICU patients at the Vienna General Hospital.


Eligibility criteria: Inclusion Criteria:

* age \> 18 years
* postoperative ICU admission
* preoperative serum creatinine within 2 weeks prior surgery

Exclusion Criteria:

* age \< 18 years
* no surgery prior to ICU admission
* renal transplantation prior ICU admission
* chronic renal replacement therapy
* peritoneal dialysis
* missing preoperative serum creatinine within 2 weeks prior surgery

Primary outcomes:
measure: 28 day mortality
timeFrame: 28 days
Secondary outcomes:
measure: ICU length of stay
timeFrame: 1 year
measure: receipt and duration of mechanical ventilation
timeFrame: 1 year
measure: receipt and duration of renal replacement therapy
timeFrame: 1 year
measure: 1-year all cause mortality
timeFrame: 1 year
Other outcomes:
Locations:
city: Vienna
country: Austria
facility: Medical University of Vienna
Study officials:
References: