The goal of a new study published in Gynecologic Oncology was todetermine the incidence of postoperative acute kidney injury (AKI) after open gynecologic surgery within enhanced recovery after surgery (ERAS); compare AKI in pre-ERAS and ERAS cohorts; and identify factors associated with AKI.

In this study, postoperative AKI in patients who underwent open gynecologic surgery at one institution before and after ERAS implementation was compared. 

The findings revealed that in 1334 ERAS and 191 pre-ERAS patients, postoperative AKI incidence was higher in the ERAS cohort. While in 166 matched pairs, ERAS patients had higher incidence and odds of AKI. Within ERAS, AKI was associated with older age, Charlson Comorbidity Index score ≥ 3 and higher intraoperative estimated blood loss, fluid administration and hypotension lasting >5 min. On the other hand, ERAS patients with AKI had longer hospital stays and more readmissions, as well as grade 3+ complications.

Hence, the incidence and odds of postoperative AKI was higher after gynecologic surgery within ERAS. Complications were more likely in patients with AKI. It was stated that potential strategies to prevent postoperative AKI include perioperative fluid and blood pressure optimization.

Source: Gynecologic Oncology. 2021 Aug 13;S0090-8258(21)00651-X.doi: 10.1016/j.ygyno.2021.08.006.