Baseline Pulse Pressure, Acute Kidney Injury, and Mortality After Noncardiac Surgery.
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BACKGROUND: Increased pulse pressure (PP) is an important independent predictor of cardiovascular outcome and acute kidney injury (AKI) after cardiac surgery. The objective of this study was to determine whether elevated baseline PP is associated with postoperative AKI and 30-day mortality after noncardiac surgery. METHODS: We evaluated 9125 adult patients who underwent noncardiac surgery at Duke University Medical Center between January 2006 and December 2009. Baseline arterial blood pressure was defined as the mean of the first 5 measurements recorded by the automated record keeping system before inducing anesthesia. Multivariable logistic regression analysis was performed to determine whether baseline PP adjusted for other perioperative risk factors was independently associated with postoperative AKI and 30-day mortality. RESULTS: Of the 9125 patients, the baseline PP was <40 mm Hg in 1426 (15.6%), 40-80 mm Hg in 6926 (75.9%), and >80 mm Hg in 773 (8.5%) patients. The incidence of AKI was 19.8%, which included 8.4% (151 patients) and 4.2% (76 patients) who experienced stage II and III AKI, respectively. In the risk-adjusted model for postoperative AKI, elevated baseline PP was associated with higher odds for postoperative AKI (adjusted odds ratio [OR] for every 20 mm Hg increase in PP, 1.17; 95% confidence interval [CI], 1.10-1.25; P < .0001). Also elevated baseline preoperative PP was significantly associated with mild (stage I; OR, 1.19; 95% CI, 1.11-1.27; P < .0001), but not with more advanced stages of postoperative AKI or with an incremental risk for 30-day mortality. CONCLUSIONS: We found a significant association between elevated baseline PP and postoperative AKI in patients who underwent noncardiac surgery. However, elevated PP was not significantly associated with more advanced stages of postoperative AKI or 30-day mortality in these patients.
Published Version (Please cite this version)10.1213/ANE.0000000000001557
Publication InfoAronson, Solomon; Fontes, Manuel Lopes; Gan, Tong Joo; Karhausen, Jorn; Kertai, Miklos David; Li, Yi-Ju; ... White, WD (2016). Baseline Pulse Pressure, Acute Kidney Injury, and Mortality After Noncardiac Surgery. Anesth Analg, 123(6). pp. 1480-1489. 10.1213/ANE.0000000000001557. Retrieved from https://hdl.handle.net/10161/13945.
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Professor of Anesthesiology
Solomon Aronson, MD, MBA, FACC, FACCP, FAHA, FASE Solomon Aronson is a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. Dr. Aronson earned his BS in molecular biology with distinction at the University of Wisconsin in Madison, and his MD with honors in research at the Medical College of Wisconsin in Milwaukee. After completing an anesthesiology residency including a year as chief resident at the Univer
Consulting Professor in the Department of Anesthesiology
My current research interests include postoperative nausea and vomiting (PONV), acute postoperative pain, clinical pharmacology of anesthetic drugs and resuscitation fluids as well as database research in postoperative outcomes. Improving Outcome in Surgical Patients: Nausea and vomiting is regarded as one of the most unpleasant experiences in postoperative recovery. To date, there is no single antiemetic which can satisfactorily control PONV. My interests concentrate o
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Assistant Professor of Anesthesiology
Associate Professor of Anesthesiology
Associate Professor of Biostatistics and Bioinformatics
My research interest is in statistical genetics, primarily in statistical method development and its application for genetic research of human complex diseases. Here is the list of research topics: Statistical genetics: I have involved in the development of several family-based association methods for quantitative traits with or without censoring, and for detecting X-linked genes. With the availability of next generation sequencing data, we have ongoing projects to develop
Adjunct Associate Professor in the Department of Anesthesiology
1. Animal models of Subarachnoid Hemorrhage (SAH) induced Cerebral Vasospasm 2. Pathogenesis of Cerebral Vasospasm following SAH 3. Translational Research in SAH 4. Long-term Outcome following Endovascular Coiling of Unruptured Cerebral Aneurysms
Associate Professor of Anesthesiology
Clinical and research interests are Enhanced Recovery and Perioperative Medicine; with particular interests in fluid management, and perioperative optimization of the high-risk non-cardiac surgery patient.
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