Incidence of and factors associated with acute kidney injury after scoliosis surgery in pediatric patients
- PDF / 1,104,450 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 15 Downloads / 232 Views
CASE SERIES
Incidence of and factors associated with acute kidney injury after scoliosis surgery in pediatric patients Jamey E. Eklund1,2 · Shikhar H. Shah3 · Daniel S. Rubin4 · Ankit I. Mehta5 · Evgueni M. Minev6 · Helen H. Lee1,2 · Steven Roth1 Received: 3 January 2020 / Accepted: 20 April 2020 © Scoliosis Research Society 2020
Abstract Purpose We sought to identify the national incidence of acute kidney injury (AKI) associated with pediatric posterior spinal fusion (PSF) surgery for scoliosis, and to determine factors that increase risk. Methods The 1998–2014 National Inpatient Sample (NIS), a large United States hospital discharge database, was queried for discharges aged 0–17 years with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for scoliosis undergoing PSF for the outcome of AKI. Discharges were divided into those with AKI and unaffected. We fit adjusted logistic regression models to yield point estimates, odds ratios, 95% confidence intervals, and p values for the weighted, national population sample with postulated risk factors. The fit of the multivariable regression model was tested using the Hosmer–Lemeshow test, and collinearity using the variance inflation factor. Results The NIS contained 103,270 weighted discharges meeting inclusion criteria. AKI incidence was 0.1%. Multivariable logistic regression model showed significantly increased odds ratios with thrombocytopenia, rhabdomyolysis, chronic kidney disease, abnormal coagulation, and male sex. AKI increased both hospital stay and cost by threefold compared to unaffected children. Conclusion This study suggests that AKI after pediatric PSF is rare. It is associated with abnormal coagulation, chronic kidney disease, and rhabdomyolysis, but not with the number of vertebral levels fused. Female sex appears to be protective. The retrospective nature of study and reliance on ICD-9-CM codes may under-represent the incidence of AKI in pediatric PSF patients. Keywords Acute kidney injury · Pediatric · Posterior spinal fusion · Retrospective study · Scoliosis Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43390-020-00126-0) contains supplementary material, which is available to authorized users. * Jamey E. Eklund [email protected] 1
Department of Anesthesiology, University of Illinois Hospital and Health Sciences, 1740 West Taylor Street, Suite 3200 W, M/C 515, Chicago, IL 60612, USA
2
Department of Anesthesiology, Shriners Hospital for Children, Chicago, Chicago, IL, USA
3
Department of Anesthesiology, Walter Read National Military Medical Center, Bethesda, MD, USA
4
Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA
5
Department of Neurosurgery, University of Illinois Hospital and Health Sciences, Chicago, IL, USA
6
Nephrology Associates of Northern Illinois and Indiana, Mount Prospect, IL, USA
Introduction Once considered a rare disease, pediatric acute kidney injury (AKI) has gained a
Data Loading...
