Abstract
Introduction
The clinical importance of postoperative acute kidney injury (AKI) in patients undergoing
general thoracic surgery is unclear. We aimed to systematically review the incidence,
risk factors, and prognostic implications of AKI as a complication after general thoracic
surgery.
Methods
We searched PubMed, EMBASE, and the Cochrane Library from January 2004 to September
2021. Observational or interventional studies that enrolled ≥50 patients undergoing
general thoracic surgery and reported postoperative AKI defined using contemporary
consensus criteria were included for meta-analysis.
Results
Thirty-seven articles reporting 35 unique cohorts were eligible. In 29 studies that
enrolled 58,140 consecutive patients, the pooled incidence of postoperative AKI was
8.0% (95% confidence interval [CI]: 6.2-10.0). The incidence was 3.8 (2.0-6.2) % after
sublobar resection, 6.7 (4.1-9.9) % after lobectomy, 12.1 (8.1-16.6) % after bilobectomy/pneumonectomy,
and 10.5 (5.6-16.7) % after esophagectomy. Considerable heterogeneity in reported
incidences of AKI was observed across studies. Short-term mortality was higher (unadjusted
risk ratio: 5.07, 95% CI: 2.99-8.60) and length of hospital stay was longer (weighted
mean difference: 3.53, 95% CI: 2.56-4.49, d) in patients with postoperative AKI (11
studies, 28,480 patients). Several risk factors for AKI after thoracic surgery were
identified.
Conclusions
AKI occurs frequently after general thoracic surgery and is associated with increased
short-term mortality and length of hospital stay. For patients undergoing general thoracic
surgery, AKI may be an important postoperative complication that needs early risk
evaluation and mitigation.
Keywords
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Article info
Publication history
Published online: March 02, 2023
Accepted:
January 27,
2023
Received in revised form:
December 28,
2022
Received:
July 6,
2022
Identification
Copyright
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