ArticleShock (Augusta, Ga.)2017
Acute Kidney Injury Following Exploratory Laparotomy and Temporary Abdominal Closure.
Article in Shock (Augusta, Ga.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Incidence and risk factors of acute kidney injury after abdominal surgery: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Incidence, risk factors, and outcomes of acute kidney injury in patients undergoing emergency laparotomy - A prospective observational exploratory study.Indian journal of anaesthesia · 2024Article
- Postoperative Acute Kidney Injury by Age and Sex: A Retrospective Cohort Association Study.Anesthesiology · 2023Article
- Obese trauma patients have increased need for dialysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- The impact of standardized protocol implementation for surgical damage control and temporary abdominal closure after emergent laparotomy.The journal of trauma and acute care surgery · 2019Article
- Hypertonic saline resuscitation after emergent laparotomy and temporary abdominal closure.The journal of trauma and acute care surgery · 2018Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAcute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 h following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality.
methodsWe performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT). Kidney Disease: Improving Global Outcomes AKI stages were assessed on admission, initial TAC, and following TAC at 48 h, 96 h, and 7 d. Multivariate regression was performed to identify risk factors for AKI and inpatient mortality.
resultsFifty-seven percent of all patients developed AKI within 7 days of laparotomy (stage 1: 14%, 2: 21%, 3: 22%). The prevalence of AKI peaked 48 h following TAC, and stage correlated with inpatient mortality (stage 0: 7%, 1: 13%, 2: 19%, 3: 37%, P < 0.001). Overall mortality was 14%. Factors predictive of stage 2 or 3 AKI at 48 h included age >65 years (OR 2.6 [95% CI 1.4-4.9]), NPWT output >30 mL/h from first TAC to 48 h (2.0 [1.1-3.9]), and three parameters at initial laparotomy: mean arterial pressure <60 mm Hg (2.9 [1.0-8.5]), temperature <36°C (2.1 [1.1-3.8]), and anion gap >21 mEq/L (1.9 [1.0-3.7]). AKI was an independent predictor of inpatient mortality (5.5 [2.5-11.8]).
conclusionsAKI is common following TAC, reaches greatest prevalence 48 h after initial laparotomy, and is associated with increased mortality. NPWT fluid loss is a risk factor for AKI that is unique to TAC patients.
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