ArticleInternational journal of spine surgery2022
Intraoperative Hypotension Is Not Correlated With Acute Kidney Injury During Spinal Fusion Surgery.
Article in International journal of spine surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Effect of blood pressure threshold on adverse outcomes in patients with acute spinal cord injury: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Incidence and Risk Assessment of Acute Kidney Injury (AKI) in Spine Surgery: A Case Report and Literature Review.Journal of clinical medicine · 2025Review
- Intraoperative short-term blood pressure variability and postoperative acute kidney injury: a single-center retrospective cohort study using sample entropy analysis.BMC anesthesiology · 2024Article
- Machine learning approach to predict acute kidney injury among patients undergoing multi-level spinal posterior instrumented fusion.Journal of spine surgery (Hong Kong) · 2024Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntraoperative hypotension (IOH) has been found to be associated with organ damage, including cardiac injury and acute kidney injury (AKI). However, to our knowledge, this relationship has not been studied in a neurosurgery-specific patient population. In this report, we review our institutional experience to understand the magnitude of association between IOH in spinal fusion operations and incidence of postoperative AKI.
methodsThis retrospective cohort study included 910 patients who underwent posterior spinal fusion procedures performed in the prone position. Intraoperative variables collected and analyzed include minute-by-minute mean arterial pressure (MAP) from an arterial catheter, intermittent blood pressure cuff readings, volume of administered intravenous fluids, urine output, and all relevant vitals and administered medications. The electronic medical record was queried for additional patient data. IOH was defined as MAP <65 mm Hg for greater than 10 minutes. The primary endpoints of the study were presence and staging of AKI ( [Kidney Disease: Improving Global Outcomes] consensus classification), postoperative ileus, and postoperative troponin leak.
resultsUsing a partial correlation analysis, no association was found between IOH metrics (IOH occurrence, IOH duration >10 minutes, and total IOH time) and any outcome metrics, including AKI, except for vasopressor usage and estimated blood loss. Patient age at surgery was not associated with any outcome variables. The lack of association between IOH and AKI contrasts with existing literature; this could be due to underlying differences in our patient population or could highlight a more complex relationship between IOH and AKI than previously understood.
conclusionOccurrence and duration of IOH were not associated with AKI, postoperative ileus, troponin leak, length of stay, or any other major outcome variables in spinal fusion patients. CLINICAL RELEVANCE: These findings depart from previous literature showing a correlation between IOH and AKI and provide level 3 evidence clinically relevant to spinal surgery. Further research is needed to better understand the exact nature of this relationship. LEVEL OF EVIDENCE: 3:
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