Postoperative acute kidney injury and risk factors for major adverse kidney events within 30 days of burn surgery.

Abstract

Burn injuries can lead to severe complications across multiple organ systems, with kidney impairment being particularly common and clinically significant. Major adverse kidney events within 30 days post-surgery (MAKE30)-including death, initiation of new renal replacement therapy, or prolonged renal dysfunction-are increasingly used in clinical research to assess mid-term renal outcomes. However, studies on the incidence and risk factors of MAKE30 in burn patients remain limited. We included burn patients admitted to a single-center burn intensive care unit between 2012 and 2022, excluding those with pre-existing kidney disease. The incidence of MAKE 30 was evaluated, and logistic regression analysis was performed to identify associated risk factors. Among 848 burn patients who underwent burn surgery during the study period, 286 (33.7 %) developed MAKE30. Postoperative acute kidney injury (AKI), age, diabetes mellitus, inhalation injury, deep burn area, intraoperative vasopressor use, fresh frozen plasma transfusion, and urine output were significantly associated with MAKE30. The incidence of MAKE30 was markedly higher in patients who developed postoperative AKI compared to those who did not (89.6 % vs. 18.3 %, p < 0.001). Additionally, chronic kidney disease (CKD) was significantly more prevalent in patients with MAKE30 than in those without (12.0 % vs. 1.7 %, p < 0.001). Postoperative AKI is a significant risk factor for MAKE30 following burn surgery, and affected patients exhibit a substantially higher incidence of CKD. This study provides single-center data on incidence and its associated risk factors of MAKE30, underscoring the importance of early kidney function monitoring and intervention in this population.