High Intraoperative Serum Lactate Level is Associated with Acute Kidney Injury after Brain Tumor Resection.

IF 2.3 2区医学 Q2 ANESTHESIOLOGY

Journal of neurosurgical anesthesiology Pub Date : 2024-01-29 DOI:10.1097/ANA.0000000000000954

Seungeun Choi, Jiwon You, Yoon Jung Kim, Hyung-Chul Lee, Hee-Pyoung Park, Chul-Kee Park, Hyongmin Oh

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引用次数: 0

Abstract

Background: Postoperative acute kidney injury (AKI) is associated with poor clinical outcomes. Identification of risk factors for postoperative AKI is clinically important. Serum lactate can increase in situations of inadequate oxygen delivery and is widely used to assess a patient's clinical course. We investigated the association between intraoperative serum lactate levels and AKI after brain tumor resection.

Methods: Demographics, medical and surgical history, tumor characteristics, surgery, anesthesia, preoperative and intraoperative blood test results, and postoperative clinical outcomes were retrospectively collected from 4131 patients who had undergone brain tumor resection. Patients were divided into high (n=1078) and low (n=3053) lactate groups based on an intraoperative maximum serum lactate level of 3.35 mmol/L. After propensity score matching, 1005 patients were included per group. AKI was diagnosed using the Kidney Disease Improving Global Outcomes criteria, based on serum creatinine levels within 7 days after surgery.

Results: Postoperative AKI was observed in 53 (1.3%) patients and was more frequent in those with high lactate both before (3.2% [n=35] vs. 0.6% [n=18]; P < 0.001) and after (3.3% [n=33] vs. 0.6% [n=6]; P < 0.001) propensity score matching. Intraoperative predictors of postoperative AKI were maximum serum lactate levels > 3.35 mmol/L (odds ratio [95% confidence interval], 3.57 [1.45-8.74], P = 0.005), minimum blood pH (odds ratio per 1 unit, 0.01 [0.00-0.24], P = 0.004), minimum hematocrit (odds ratio per 1%, 0.91 [0.84-1.00], P = 0.037), and mean serum glucose levels > 200 mg/dL (odds ratio, 6.22 [1.75-22.16], P = 0.005).

Conclusion: High intraoperative serum lactate levels were associated with AKI after brain tumor resection.

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术中血清乳酸水平过高与脑肿瘤切除术后急性肾损伤有关

背景：术后急性肾损伤（AKI术后急性肾损伤（AKI）与不良的临床预后有关。识别术后急性肾损伤的风险因素在临床上非常重要。血清乳酸可在氧输送不足的情况下升高，被广泛用于评估患者的临床过程。我们研究了脑肿瘤切除术后术中血清乳酸水平与 AKI 之间的关系：我们回顾性地收集了 4131 例脑肿瘤切除术患者的人口统计学特征、病史和手术史、肿瘤特征、手术、麻醉、术前和术中血液检测结果以及术后临床结果。根据术中最高血清乳酸水平 3.35 mmol/L 将患者分为高乳酸组（1078 人）和低乳酸组（3053 人）。经过倾向评分匹配后，每组纳入 1005 名患者。根据术后7天内的血清肌酐水平，采用肾脏疾病改善全球结果标准诊断AKI：结果：53 例（1.3%）患者观察到术后 AKI，高乳酸患者术后 AKI 发生率更高，在倾向得分匹配之前（3.2% [n=35] vs. 0.6% [n=18]; P < 0.001）和之后（3.3% [n=33] vs. 0.6% [n=6]; P < 0.001）均是如此。术中预测术后 AKI 的因素有：最大血清乳酸水平 > 3.35 mmol/L（几率比 [95% 置信区间]，3.57 [1.45-8.74]，P = 0.005）、最低血液 pH 值（每 1 个单位的几率比，0.01 [0.00-0.24]，P = 0.004）、最低血细胞比容（每 1%的几率比，0.91 [0.84-1.00]，P = 0.037）和平均血清葡萄糖水平 > 200 mg/dL（几率比，6.22 [1.75-22.16]，P = 0.005）：结论：术中高血清乳酸水平与脑肿瘤切除术后的 AKI 相关。

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来源期刊

Journal of neurosurgical anesthesiology 医学-临床神经学

CiteScore

6.20

自引率

10.80%

发文量

119

审稿时长

>12 weeks

期刊介绍： The Journal of Neurosurgical Anesthesiology (JNA) is a peer-reviewed publication directed to an audience of neuroanesthesiologists, neurosurgeons, neurosurgical monitoring specialists, neurosurgical support staff, and Neurosurgical Intensive Care Unit personnel. The journal publishes original peer-reviewed studies in the form of Clinical Investigations, Laboratory Investigations, Clinical Reports, Review Articles, Journal Club synopses of current literature from related journals, presentation of Points of View on controversial issues, Book Reviews, Correspondence, and Abstracts from affiliated neuroanesthesiology societies. JNA is the Official Journal of the Society for Neuroscience in Anesthesiology and Critical Care, the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland, the Association de Neuro-Anesthésiologie Réanimation de langue Française, the Wissenschaftlicher Arbeitskreis Neuroanästhesie der Deutschen Gesellschaft fur Anästhesiologie und Intensivmedizen, the Arbeitsgemeinschaft Deutschsprachiger Neuroanästhesisten und Neuro-Intensivmediziner, the Korean Society of Neuroanesthesia, the Japanese Society of Neuroanesthesia and Critical Care, the Neuroanesthesiology Chapter of the Colegio Mexicano de Anesthesiología, the Indian Society of Neuroanesthesiology and Critical Care, and the Thai Society for Neuroanesthesia.