ObjectiveThe association of non-steroidal anti-inflammatory drugs with postoperative acute kidney injury (AKI) is controversial. However, there are few studies focusing on the association between parecoxib and postoperative AKI. Our study aimed at the possible correlation between the intraoperative administration of cyclooxygenase-2 inhibitors parecoxib and perioperative AKI.DesignA retrospective cohort study.SettingThird Xiangya Hospital of Central South University in Hunan Province, China.ParticipantsThe electronic medical records and laboratory results were obtained from 9246 adult patients (18–60 years) undergoing non-cardiac surgery performed between 1 January 2012 and 31 August 2017. Study groups were treated with or without parecoxib.InterventionsUnivariable analysis identified demographic, preoperative laboratory and intraoperative factors associated with AKI. Logistic stepwise regression was used to calculate the adjusted OR of parecoxib and AKI association.ResultsThe incidence of AKI was lower in the parecoxib-administered group (4%) than that in the group without parecoxib (6.3%, p=0.005). In the multivariable regression analysis, postoperative AKI risk reduced by 39% (OR 0.61; 95% CI 0.43 to 0.87) in the parecoxib-administered group after adjusting for interference factors. Sensitivity analysis showed that postoperative AKI risk reduced in four subgroups: eGRF <90 mL/min·1.73/m2 (OR 0.49; 95% CI 0.29 to 0.82), non-smoker (OR 0.55; 95% CI 0.37 to 0.83), blood loss <1000 mL (OR 0.55; 95% CI 0.37 to 0.83) and non-hypotension (OR 0.57; 95% CI 0.38 to 0.84).ConclusionsThus, parecoxib is associated with a modest reduction of postoperative AKI risk among adult patients undergoing non-cardiac surgery.
Background: The association of nonsteroidal anti-inflammatory drugs with postoperative acute kidney injury is controversial. However, there are few studies focusing on the association between parecoxib and postoperative acute kidney injury. Methods: We retrospectively reviewed the electronic medical records and laboratory results of 9,246 adult patients (18–60 years) undergoing non-cardiac surgery at Third Xiangya Hospital of Central South University from January 1, 2012 to August 31, 2017. Study groups were either treated with or without parecoxib. Univariable analysis identified demographic, preoperative laboratory, and intraoperative factors associated with acute kidney injury. Logistic stepwise regression was used to calculate the adjusted odds ratio of parecoxib and acute kidney injury association. Results: The incidence of postoperative acute kidney injury was 6.06% and parecoxib was used in 0.105% of patients. The mortality was 4.64% in the acute kidney injury group. The incidence of acute kidney injury was lower in the parecoxib-administered group (4%) than in the without parecoxib-administered group (6.3%, p = 0.005). Postoperative acute kidney injury risk reduced by 33.40% in the parecoxib-administered group after adjusting for interference factors.Conclusions: Intraoperative single-dose parecoxib (40 mg or 80 mg) might reduce postoperative acute kidney injury risk in adult patients undergoing non-cardiac surgery.
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