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Published in: Journal of Anesthesia 6/2019

01-12-2019 | Acute Kidney Injury | Original Article

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

Authors: Tak Kyu Oh, In-Ae Song, Young-Tae Jeon

Published in: Journal of Anesthesia | Issue 6/2019

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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.
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Metadata
Title
Admission to the surgical intensive care unit during intensivist coverage is associated with lower incidence of postoperative acute kidney injury and shorter ventilator time
Authors
Tak Kyu Oh
In-Ae Song
Young-Tae Jeon
Publication date
01-12-2019
Publisher
Springer Singapore
Published in
Journal of Anesthesia / Issue 6/2019
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-019-02684-8

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