Incidence and Risk Factors for Acute Kidney Injury After Spine Surgery

Area of Science:

• Nephrology
• Orthopedic Surgery
• Health Services Research

Background:

• Acute kidney injury (AKI) is a common postoperative complication following spine surgery, associated with increased morbidity and healthcare costs.
• Limited data exist on specific risk factors for AKI in the context of elective spine surgery.
• Spine surgery is a prevalent procedure in the United States, highlighting the need to understand AKI risks.

Purpose of the Study:

• To determine the incidence of AKI in patients undergoing elective spine surgery.
• To identify preoperative and postoperative risk factors associated with AKI development.
• To inform strategies for reducing AKI incidence and improving patient outcomes.

Main Methods:

• Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
• Identification of patients undergoing elective spine surgery using CPT codes.
• Propensity matching and univariate/multivariate analyses to assess risk factors for AKI, defined by perioperative laboratory values.

Main Results:

• The incidence of postoperative AKI was 0.10% (373 out of 351,998 procedures).
• Patients with AKI were more likely to have higher BMI, anemia, chronic kidney disease, diabetes, hypertension, and specific preoperative lab value abnormalities.
• No statistically significant difference in AKI incidence was observed across different types of spine surgical procedures.

Conclusions:

• The incidence of AKI following elective spine surgery is low at 0.10%.
• Modifiable risk factors including anemia, chronic kidney disease, and hypertension are associated with AKI.
• Addressing these modifiable risk factors is crucial for reducing postoperative complications after spine surgery.