Incidence and Prognostic of Cardiac Surgery-Associated Acute Kidney Injury: A Spanish Multicenter Study (SCARS-AKI)
NCT07370831
Acute Kidney Disease, Acute Kidney Injury
Oviedo, Principality of Asturias, Spain
View Trial DetailsNCT Number: NCT07080086
Background The aim of this study is to explore the potential value of preoperative biological age as a predictor of intraoperative hemodynamic changes and postoperative renal function injury.
Methods Collect data using medical record system and surgical anesthesia system, and gather patients who have undergone surgery. Calculate the preoperative biological age of the patient and analyze the correlation between preoperative biological age accelerated aging and intraoperative hemodynamics and postoperative renal function damage.
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Observational
With the intensification of population aging, the number of patients undergoing surgical procedures has been increasing year by year. However, traditional age indicators cannot fully reflect the physiological condition and surgical risks of patients. In clinical practice, preoperative evaluation is usually based on the patient's actual age, but this method fails to fully consider individual biological differences. As a new evaluation indicator, biological age can more accurately reflect an individual's physiological status and health level by comprehensively considering multiple biomarkers. Therefore, biological age has gradually become one of the important parameters for predicting surgical risk. The stability of intraoperative hemodynamics is crucial for the prognosis of surgical patients. Research has shown that intraoperative blood pressure fluctuations, heart rate variability, and other hemodynamic abnormalities are closely related to the occurrence of postoperative complications. Postoperative renal dysfunction (AKI) is a common and serious postoperative complication, especially more common in elderly patients. Previous studies have found that the occurrence of AKI is not only related to intraoperative hemodynamic disorders, but also significantly influenced by the patient's underlying health status. However, current research on the impact of biological age on intraoperative hemodynamics and its relationship with postoperative renal function injury is still limited. Further exploration of the relationship between preoperative biological age and intraoperative hemodynamic parameters, as well as their predictive value for postoperative renal function injury, will help improve the accuracy of preoperative risk assessment, optimize intraoperative management strategies, and ultimately improve patients' postoperative prognosis. Therefore, this study aims to provide a new predictive tool for clinical practice and a basis for personalized surgical management by systematically evaluating the impact of biological age on intraoperative hemodynamics and postoperative renal function injury.
Based on hospital data, evaluate the hemodynamic fluctuations and incidence of postoperative renal function damage in patients of different biological ages undergoing high-risk surgery. The study aims to verify whether biological age can be independent of traditional clinical evaluation indicators, provide more accurate prediction of perioperative risks for patients, and provide scientific basis for individualized treatment decision-making.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Time frame: Within 7 days postoperative,
Pateints encompasses an escalation in SCr of 50% or more, an increment of at least 0.3 mg/dL within 48 hours, or the need for RRT including haemodialysis, peritoneal dialysis, continuous renal replacement therapy, and kidney transplant. It was based on the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.
Time frame: Within 8-90 days post-surgery
AKD was defined by a surge in SCr by more than 50%, or the initiation of RRT such as haemodialysis, peritoneal dialysis or continuous RRT.
Time frame: During intraoperative period
IOH was defined as the presence of intraoperative epoque with MAP below 60 mmHg.
Time frame: From induction of general anesthesia to 20 minutes post-induction.
PIH was defined as at least one measurement of SAP below 90 mmHg.
Time frame: 0-7 days post-surgery
AKI 2+ was identified as an elevation in SCr to a level at least twice that of the baseline measurement.
Time frame: During surgery
Calculate the cumulative duration below the threshold value
Time frame: During surgery
Total area under each threshold (areas under the curve (AUC) measured in mmHg*minutes).
Nanjing First Hospital, Nanjing Medical University
Other
The Effect of Preoperative Biological Age on Intraoperative Hemodynamics and Postoperative Renal Function
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