Preoperative Hemoglobin and Acute Kidney Injury in Emergency Surgery

The Association Between Preoperative Hemoglobin and Acute Kidney Injury in Emergency Surgery: A Prospective Observational Study

Optimization of hemoglobin levels for organ perfusion is essential, especially in critically ill patients. Although anemia is associated with severe organ failure, especially in coronary artery disease, the effects of blood transfusion or various interventions to increase hemoglobin levels on outcomes continue to be debated. The effects of hemoglobin levels in emergency surgery patients on the development of postoperative AKI have been investigated in a small number of studies in the literature, and clear results have not yet been reported. This study was designed to evaluate the effect of hemoglobin levels on the development of AKI after adjustment for known predictive factors.

Acute kidney injury (AKI) is a common complication in patients undergoing major surgery and is associated with both short-term morbidity and mortality and long-term adverse outcomes including the development of Chronic Kidney Failure. Optimization of hemoglobin levels for organ perfusion is essential, especially in critically ill patients. Although anemia is associated with severe organ failure, especially in coronary artery disease, the effects of various interventions such as blood transfusion or increasing hemoglobin levels on outcomes continue to be debated. This prospective observational study was planned to evaluate the effect of hemoglobin levels before emergency surgery on the development of postoperative AKI.

Emergency operated patients will be divided into two groups as Group AKI and Group non-AKI according to the development of postoperative renal failure. Postoperative AKI diagnosis and severity will be evaluated according to serum creatinine and/or urine output according to KDIGO (Kidney Disease: Improving Global Outcomes criteria).

Demographic characteristics of the patients, preoperative complete blood count, blood biochemistry characteristics, hemodynamic variables, fluid replacement, blood and blood product replacements, surgical characteristics, development and severity of AKI in the postoperative period will be recorded and the effect of hemoglobin level on the development of AKI will be evaluated.

Inclusion Criteria:

• Patients undergoing emergency non-cardiac surgery

Exclusion Criteria:

• Known renal failure
• Need for reoperation within 48 hours postoperatively
• Exit status within 48 hours postoperatively
• Known hematological disease
• Known kidney transplantation
• Urgent surgery planned due to urinary system related diseases
• Patients who did not accept to participate in the study