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The association between early peripheral perfusion and acute kidney injury in patients admitted to the intensive care unit following major noncardiac surgery
Received date: 2024-09-18
Online published: 2025-01-26
Objective To investigate the association between early peripheral perfusion index （PPI） and acute kidney injury （AKI） in patients admitted to the intensive care unit （ICU） following major noncardiac surgery. Methods This retrospective cohort study was conducted at a single center. Adult patients consecutively enrolled were those admitted to the ICU after major noncardiac surgery. PPI measurements were collected within the first 6 hours post-surgery. The primary outcome assessed was the occurrence of AKI within 7 days after surgery. Multivariate logistic regression analysis was employed to adjust for confounding factors， while receiver operating characteristic （ROC） curve analysis determined the most predictive cutoff PPI. Results The study included a total of 444 patients who underwent noncardiac surgery. The incidences of postoperative AKI and severe AKI were 9.23% and 1.13%， respectively. Early postoperative PPI levels exhibited a skewed distribution， with a median value of 3.02 （2.02， 4.24）. After adjusting for various perioperative variables， PPI was found to be independently correlated with the occurrence of postoperative AKI （OR = 0.734， 95% CI： 0.580~0.930， P = 0.010）， as indicated by an area under the ROC curve of 0.680 2 （95% CI： 0.602 2 ~ 0.758 2， P < 0.001）. Using a cutoff value of ≤ 2 .04 for PPI， the sensitivity and specificity for predicting postoperative AKI were determined to be approximately at 53.7 % and 77.2 % respectively. Further analysis revealed that patients with PPI ≤ 2.04 had a higher incidence of severe postoperative complications as well as prolonged mechanical ventilation duration and hospital stay. Conclusions A prompt reduction in postoperative PPI usage was found to be linked with the incidence of AKI occurring within 7 days following major noncardiac surgery.
Yujian CUI , Yuke LI , Sainan ZHU , Shuangling LI , Nan. LI . The association between early peripheral perfusion and acute kidney injury in patients admitted to the intensive care unit following major noncardiac surgery[J]. The Journal of Practical Medicine, 2025 , 41(2) : 195 -201 . DOI: 10.3969/j.issn.1006-5725.2025.02.006
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