Acute kidney injury (AKI) is a recognised postoperative complication following primary hip/knee arthroplasty surgery. The aim of this study was to determine causative and potentially modifiable risk factors associated with postoperative AKI. Standard data were collected for 413 consecutive arthroplasty patients, both retrospectively and prospectively. Univariate and multivariate analyses were performed to identify any potential causative factors. Eight percent of patients developed postoperative AKI. Univariate analysis found increasing age, history of previous chronic kidney disease and requirement for postoperative intravenous fluids to be risk factors for AKI. The multivariate regression analysis model identified age and volume of postoperative fluid prescription as predictive of postoperative AKI. Antibiotic regime and prescription of non-steroidal anti-inflammatory drugs had no significant effect on the risk of AKI. No patients required dialysis but length of stay increased by 50% in the AKI group. Postoperative AKI may result in significant postoperative morbidity and increased length of stay, and may necessitate invasive therapies such as dialysis. Episodes of AKI could also predispose to future similar episodes and are associated with a long-term decrease in baseline renal function. This study has demonstrated that the identified risk factors are generally non-modifiable. Further work is suggested to determine whether targeted interventions in high risk patients would reduce the incidence of AKI.
In this study, we report the prevalence and aetiology of hyponatraemia after surgery for hip fracture. We conducted a retrospective analysis of 144 consecutive patients who underwent surgery after sustaining a hip fracture. Data were collected from medical case records, operative notes and electrolyte results. Univariate and logistic regression analysis was conducted in order to identify significant independent risk factors for the development of hyponatraemia. Mild hyponatraemia was relatively common affecting 19 % (28/ 144) of patients pre-operatively and 28 % (40/144) post-operatively. However, moderate/severe hyponatraemia (plasma sodium concentration <130 mmol/l) was uncommon, affecting 1 % (2/144) of patients at the time of admission and 6 % (9/144) of patients post-operatively. Univariate analysis identified: female gender, pre-operative hyponatraemia, hypotonic fluid administration and thiazide diuretic use as being associated with the development of post-operative hyponatraemia. Age had no statistically significant association. Logistic regression analysis identified female gender, pre-operative hyponatraemia and hypotonic fluid administration being significant, independent risk factors for the development of hyponatraemia. Age and thiazide diuretics both had positive risk associations; however, these were not statistically significant. Mild hyponatraemia is a common finding in hip fracture patients; however, more severe cases are relatively rare. Preoperative hyponatraemia and hypotonic fluid administration were the only modifiable risk factors identified.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.