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Postoperative Hypoalbuminemia as a Predictor of Acute Kidney Injury After Open Repair of Ruptured Abdominal Aortic Aneurysm

 Hei Jin Yoon  ;  Tae-Hoon Kim  ;  Da Eun Ko  ;  Jong-Wook Song  ;  Narhyun Min  ;  Sung Yeon Ham 
 WORLD JOURNAL OF SURGERY, Vol.47(12) : 3382-3393, 2023-12 
Journal Title
Issue Date
Acute Kidney Injury* / epidemiology ; Acute Kidney Injury* / etiology ; Aortic Aneurysm, Abdominal* / complications ; Aortic Aneurysm, Abdominal* / surgery ; Aortic Rupture* / surgery ; Blood Vessel Prosthesis Implantation* / adverse effects ; Humans ; Hypoalbuminemia* / complications ; Postoperative Complications / epidemiology ; Postoperative Complications / etiology ; Postoperative Complications / surgery ; Retrospective Studies ; Risk Factors ; Serum Albumin / analysis ; Treatment Outcome
Background Perioperative hypoalbuminemia has a prognostic effect on mortality and morbidity in various cohorts. Patients undergoing open repair of ruptured abdominal aortic aneurysms (rAAA) are at a high risk of hypoalbuminemia due to bleeding and underlying diseases. Hence, this study aimed to investigate the predictive value of immediate postoperative hypoalbuminemia for the risk for acute kidney injury (AKI) in patients undergoing open rAAA repair. Methods We retrospectively reviewed 143 patients who underwent open rAAA repair between January 2008 and May 2022. The patients were divided into two groups according to the presence of postoperative AKI. The perioperative serum albumin levels of the two groups were compared. The patients were further divided into two groups based on the median immediate postoperative albumin level (2.4 g/dL). The incidence of AKI was compared between the two groups. Multivariate logistic regression analysis was performed to assess the predictors of postoperative AKI. Kaplan-Meier survival curves were used to evaluate potential of AKI and albumin level as prognostic factors for mortality. Results Immediate postoperative serum albumin was significantly lower in the AKI group than in the non-AKI group (2.11 +/- 0.62 g/dL vs. 2.59 +/- 0.62 g/dL, p\ 0.001). The incidence of postoperative AKI was significantly higher in patients with albumin B 2.4 g/dL than in patients with albumin[ 2.4 g/dL (53.8% vs. 27.7%, p = 0.002). Immediate postoperative albumin level was an independent predictor of AKI (Odds ratio [OR], 0.310; 95% confidence interval [CI] 0.165-0.583, p\ 0.001) and 1-year mortality (OR, 0.230; 95% CI 0.098-0.542, p = 0.001). Conclusions Immediate postoperative hypoalbuminemia was associated with postoperative AKI and mortality in patients with rAAA.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Da Eun(고다은)
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3987-0057
Min, Nar Hyun(민나현) ORCID logo https://orcid.org/0000-0003-2367-3489
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Yoon, Hei Jin(윤혜진)
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
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