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Association of perioperative weight-based fluid balance with 30-day mortality and acute kidney injury among patients in the surgical intensive care unit

  • Tak Kyu Oh
  • In-Ae Song
  • Sang-Hwan Do
  • Sanghoon Jheon
  • Cheong LimEmail author
Original Article
  • 73 Downloads

Abstract

Purpose

Perioperative positive fluid balance has negative effects on short-term outcomes, such as surgical complications, although the associations with postoperative mortality remain unclear. This study evaluated the associations of perioperative fluid balance (FB) with 30-day mortality and acute kidney injury (AKI) after postoperative intensive care unit (ICU) admission.

Methods

This retrospective study evaluated data from adult patients who were admitted to the ICU after surgery during 2012–2016. Weight-based cumulative FB (%) was calculated for 3 time periods [postoperative day (POD) 0 (24 h), 0–1 (48 h), and 0–2 (72 h)] and was categorized as positive (≥ 5%), mild to moderate positive (5–10%), severe positive (> 10%), normal (0–5%), or negative (< 0%).

Results

Data from 7896 patients were included in the analysis. The multivariable Cox regression model revealed that increased 30-day mortality was associated with positive FB groups (≥ 5%) compared to normal FB groups (0–5%) during 3 time periods [hazard ratio (HR) on POD 0 (24 h): 1.87, HR on POD 1 (48 h): 1.91, and HR on POD 2 (72 h): 4.62, all P < 0.05]. These trends were more evident in the severe positive FB group across the three time periods. Additionally, similar association was found for incidence of AKI during POD 0–2.

Conclusion

Perioperative cumulative weight-based FB was positively associated with increased postoperative 30-day mortality or postoperative AKI in ICU patients; this association was consistent with the positive FB on POD 0 (24 h), 0–1 (48 h), and 0–2 (72 h).

Keywords

Anesthesia Critical care Mortality 

Notes

Acknowledgements

The authors thank the Medical Research Collaborating Center at Seoul National University Bundang Hospital for the revisions with regard to statistical analyses. They are particularly grateful to their statistician, Eunjeong Ji, Ph.D., for her contribution on the statistical analysis.

Supplementary material

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Copyright information

© Japanese Society of Anesthesiologists 2019

Authors and Affiliations

  • Tak Kyu Oh
    • 1
  • In-Ae Song
    • 1
  • Sang-Hwan Do
    • 1
  • Sanghoon Jheon
    • 2
  • Cheong Lim
    • 2
    Email author
  1. 1.Department of Anesthesiology and Pain MedicineSeoul National University Bundang HospitalSeongnamSouth Korea
  2. 2.Department of Thoracic and Cardiovascular SurgerySeoul National University Bundang HospitalSeongnamSouth Korea

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