Intraoperative hypotension is associated with acute kidney injury in noncardiac surgery: An observational study

BACKGROUND Perioperative acute kidney injury (AKI) is common and increases the risk of morbidity and mortality. OBJECTIVES To determine the association between intraoperative hypotension, defined as an individual decrease from baseline and the risk of perioperative AKI. DESIGN Observational cohort study. SETTING Karolinska University Hospital, Stockholm, Sweden, from October 2012 to May 2013 and October 2015 and April 2016. PATIENTS All adult patients undergoing major elective noncardiac surgery who were scheduled for an overnight admission in the postoperative unit were included. Patients undergoing phaeochromocytoma surgery were excluded. DATA COLLECTION Preoperative risk factors (comorbidities), intraoperative events (hypotension defined as a more than 40 or 50% decrease in SBP relative to each patient's baseline and lasting more than 5 min) and postoperative data were collected from medical records. MAIN OUTCOME MEASURES AKI within the first two postoperative days. RESULTS Of the final cohort of 470 patients, 127 (27%) developed AKI in the perioperative period. AKI was associated with male sex [(66 vs. 48%) P 40%, 70 vs. 57%, P = 0.013; >50%, 20 vs. 12%, P = 0.024) and greater blood loss (800 vs. 400 ml, P 

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