THE SEVERITY OF ACUTE KIDNEY INJURY PREDICTS MORBIDITY AND MORTALITY IN SURGICAL PATIENTS AMONG EMERGENCY LAPAROTOMIES: OBSERVATIONAL COHORT STUDY

Rajesh Rai*, Nurul Bintiaziz, Kerissa Ramasar, Kaira Jakobsh, Adriana Kiatipis and Prof. Chwanrow Baban

ABSTRACT

Background: Acute Kidney Injury (AKI) patients undergoing emergency surgery have an increased risk of complications and mortality. We examined the incidence, mortality, hospital stay, and renal replacement therapy of patients who presented with AKI and underwent emergency laparotomies. Methods: This is an observational study done at Beaumont Hospital, Dublin. Patients who were included in the study had AKI and underwent laparotomies within 48 hours of admission. These patients were admitted to surgical care from the emergency department between 2012 and 2017. The main outcome analyzed was 30-day mortality. The other outcomes measured were length of stay, stage of AKI, and increased need for renal replacement therapy. Results: In our study, 641 patients underwent emergency laparotomies. 13.9% of patients (n=86) presented with AKI after excluding 3.9% of patients (n=24) with chronic kidney disease (CKD). Out of 86 AKI patients, 31.4% of patients (n=27) died after emergency laparotomy and 6.9% of patients (n=6) required renal replacement therapy. The relative risk of mortality was highest in stage 3 AKI (69%) and length of stay was also longest in stage 3 AKI 109(13-232) days. Conclusion: AKI is an important predictor of mortality for emergency laparotomies, and it is associated with an increased length of stay and renal replacement therapy requirement.

Keywords: Acute kidney injury, Postoperative, Incidence, Prognosis, Risk factors, Emergency Laparotomy.