Vaught et al reported risk factors for acute kidney injury in women undergoing major gynecological surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Florida at Gainesville.


Patient selection: woman undergoing major gynecological surgery


Outcome: acute kidney injury (AKI), any stage


Perioperative risk factors from multivariate logistic regression model:

(1) increasing age (odds ratio 1.015 per year increase, but starting age not specified)

(2) emergency surgery (odds ratio 4.1)

(3) weekend admission (odds ratio 1.8)

(4) congestive heart failure on admission (odds ratio 2.3)

(5) COPD on admission (odds ratio 1.8)

(6) diabetes mellitus AND (non-malignant diagnosis = benign tumor or nonneoplastic, odds ratio 2.4)

(7) diagnosis (odds ratio for metastatic cancer 4, for nonmetastatic cancer 1.8, for nonneoplastic 1.6, versus 1 for benign tumor)


The presence of AKI significantly increased the risk of a major adverse event (odds ratio 9).


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