Variability of blood pressure and risk of postoperative acute kidney injury in patients undergoing surgery for acute aortic dissection: A 11‐year single‐center study

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 25; no. 5; pp. 463 - 469
• Main Authors: Li, Yan, Zheng, Tingting, Zhu, Jianfei, Chen, Yanjun, Chen, Yun, Sun, Shuai
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.05.2023; John Wiley and Sons Inc; Wiley
• Subjects: acute kidney injury; Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Alcohol use; Antihypertensives; Aortic dissection; Aortic Dissection - epidemiology; Aortic Dissection - surgery; Blood Pressure; Blood Pressure Variability; Cardiovascular disease; Creatinine; Diabetes; Glucose; Heart failure; Heart rate; Hemoglobin; Hospitalization; Hospitals; Humans; Hypertension; Hypertension - complications; Hypertension - etiology; Kidney diseases; Leukocytes; Mortality; Original; Patients; Pharmacists; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Risk Factors; Surgery; blood pressure variability; aortic dissection; acute kidney injury
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/jch.14654

In patients receiving surgery, increased blood pressure variability may contribute to the onset of acute kidney injury (AKI). However, the extent and significance of blood pressure variability in patients undergoing aortic dissection surgery have yet to be determined. The authors analyzed all patients operated for aortic dissection at Peking University Shenzhen Hospital from January 1, 2011 to December 31, 2021. Preoperative blood pressure variability was expressed as standard deviation, coefficient of variation (CV), and range. The primary outcome was postoperative AKI. After multivariate analysis, systolic blood pressure variability was found to be independently associated with AKI after aortic dissection surgery. The odds ratios and 95% confidence intervals for standard deviation, CV, and systolic blood pressure range were 1.232 (1.011–1.500), 1.451 (1.058–1.991), and 1.138 (0.986–1.288) for postoperative AKI, respectively. However, there was no significant relationship between diastolic blood pressure variability and AKI after aortic dissection surgery. Finally, in patients undergoing surgery for aortic dissection, the variability of systolic blood pressure is actually an important factor in the development of AKI.