ArticleBJS open2021
Impact of postoperative acute kidney injury in patients undergoing major gastrointestinal surgery on 1-year survival and renal outcomes: a national multicentre cohort study.
Article in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Long-term risks of adverse kidney outcomes after acute kidney injury: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Pooled it
- The effect of prehabilitation on the postoperative outcomes of patients undergoing colorectal surgery: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Novel biological risk factors for 7-day postoperative kidney injury in elective major non-cardiac surgery: a retrospective observational study.Anaesthesia · 2025Observational
- Acute kidney injury after major hepatectomy: association with postoperative complications and post-hepatectomy liver failure.BJS open · 2025Article
- Intraoperative fluid management is not predictive of AKI in major pancreatic surgery: a retrospective cohort study.Journal of anesthesia, analgesia and critical care · 2024Article
- Preoperative geriatric nutritional risk index and neutrophil-to-lymphocyte ratio relate to postoperative acute kidney injury in elderly patients undergoing laparoscopic abdominal surgery.Food & nutrition research · 2024Article
- Preoperative urine neutrophil gelatinase-associated lipocalin predicts mortality in colorectal cancer patients after laparoscopic surgery: A single-center study.Health science reports · 2023Article
- Long-term healthcare use after postoperative complications: an analysis of linked primary and secondary care routine data.BJA open · 2023Article
- Validation of the OAKS prognostic model for acute kidney injury after gastrointestinal surgery.BJS open · 2022Article
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Abstract
backgroundThe intermediate-term impact of acute kidney injury (AKI) in patients after major gastrointestinal and liver surgery has not been well characterized. This study aimed to evaluate the 1-year mortality rate and renal outcomes associated with postoperative AKI in a national prospective cohort.
methodsThis prospective multicentre, observational cohort with 1-year postoperative follow-up included adults undergoing major gastrointestinal and liver surgery across the UK and Ireland between 23 September and 18 November 2015. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. The primary outcome was death at 1-year after surgery, and the secondary outcome was Major Adverse Kidney Events (MAKE-365). Cox proportionate and multilevel logistic regression were used to account for case mix.
resultsOf 5745 patients across 173 centres, 1-year follow-up data was completed for 3504 patients (62.2 per cent, 126 centres), with attrition largely explained by centre non-participation (63.1 per cent). Some 13.6 per cent (475 of 3504) patients developed AKI by 7 days after surgery (stage 1: 9.2 per cent; stage 2/3: 4.3 per cent). At 1 year, 10.8 per cent (378 patients) experienced a MAKE-365 endpoint (303 patients had died, 61 had renal replacement therapy and 78 had renal dysfunction). Patients who experienced AKI by 7 days after surgery had a higher hazard of death at 1 year for KDIGO stage 1 (hazard ratio 1.50 (95 per cent c.i. 1.08 to 2.08), P = 0.016) and KDIGO stage 2/3 (hazard ratio 2.96 (95 per cent c.i. 2.02 to 4.33), P < 0.001). Both KDIGO stage 1 (odds ratio 2.09 (95 per cent c.i. 1.50 to 2.92), P < 0.001) and stage 2/3 (odds ratio 9.26 (95 per cent c.i. 6.31 to 13.59), P < 0.001) AKI were independently associated with MAKE-365.
conclusionAKI events within 7 days after gastrointestinal or liver surgery are associated with significantly worse survival and renal outcomes at 1 year.
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