News: Cardiac surgery practices influence development of post-operative AKI, study suggests

A new study has found an association between hospital- and clinician-level operating practices and the development of acute kidney injury (AKI) post-cardiac operation.

The study, released in JAMA Network Open, examined 23,389 cardiac surgery patients (all above 18 years of age) who had surgeries at eight different locations in the United States. The patients underwent surgery anytime between January 2014 to March 2022.

Within the study population, 4779 patients (20.4%) developed AKI stage 1 or greater, including 1008 (4.3%) with stage 2 or greater and 252 (1.1%) with stage 3. According to the researchers, 20.4% of the patients reviewed developed some form of AKI after cardiac surgery.

“We observed clinician- and hospital-level variations in both AKI rates and operating room practices plausibly playing a role in AKI, including inotrope infusion, vasopressor infusion, RBC [red blood cell] transfusion, and fluid volume administration,” the authors noted. “Through an analysis of clinician- and hospital-level practice variation, we observed that adjusted rates of AKI were higher across hospitals with higher inotrope infusion rates and lower across clinicians with higher RBC [red blood cell] transfusion rates.”

Based on their research, the authors underscored the importance of investigating pre and postoperative interventions to help better understand the relationship between operating room practices and reducing the likelihood of post-operative AKI through such interventions.

Editor’s note: To read the JAMA Network Open study, click here.