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Admission to the surgical intensive care unit during intensivist coverage is associated with lower incidence of postoperative acute kidney injury and shorter ventilator time

  • Tak Kyu OhEmail author
  • In-Ae Song
  • Young-Tae Jeon
Original Article
  • 43 Downloads

Abstract

Purpose

This study aimed to assess the impact of intensivist coverage on the incidence of acute kidney injury (AKI) and ventilator time among patients postoperatively admitted to the intensive care unit (ICU).

Methods

Adult patients postoperatively admitted to the ICU between January 2012 and December 2017 were retrospectively enrolled. The incidence of AKI within 72 h of surgery and the postoperative ventilator time were compared between the groups covered by intensivists and non-intensivists.

Results

After propensity score (PS) matching, 5650 patients were included in the final analysis (2825 patients in each group). The incidence rate of AKI was significantly higher in the non-intensivist coverage group than in the intensivist coverage group (22.7% vs. 20.2%; P = 0.023). Moreover, logistic regression analysis in the PS-matched cohort showed that the incidence of postoperative AKI in the non-intensivist coverage group increased by 16% compared to that in the intensivist coverage group (odds ratio 1.16, 95% confidence interval 1.02–1.32; P = 0.023). Additionally, the median time of ventilator use in the non-intensivist coverage group was significantly longer than that in the intensivist coverage group [7.8 (interquartile range, IQR 2.6–13.8) h vs. 5.3 (1.8–8.3) h; P < 0.001].

Conclusion

High-intensity intensivist coverage is associated with a lower risk of postoperative AKI and shorter postoperative ventilator times. These findings suggested that in addition to medical trainees, initial management of surgical ICU patients by intensivists may lower the risk of AKI and facilitate early weaning from mechanical ventilation.

Keywords

Acute kidney injury Critical illness Intensive care units Ventilators Mechanical 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

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Supplementary material 1 (DOCX 13 kb)
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Supplementary material 2 (DOCX 14 kb)
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Supplementary material 3 (DOCX 14 kb)
540_2019_2684_MOESM4_ESM.TIF
Figure S1. Distribution of propensity scores before and after propensity score matching (TIFF 198 kb)

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Copyright information

© Japanese Society of Anesthesiologists 2019
corrected publication 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain MedicineSeoul National University Bundang HospitalSeongnamSouth Korea
  2. 2.Department of Anesthesiology and Pain Medicine, College of MedicineSeoul National UniversitySeoulSouth Korea

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