Abstract
Objective: Acute kidney injury (AKI) is one of the complications caused by laparotomy surgery with general anesthesia. Perfusion index (PI) and vasoactive-inotropic score (VIS) have the potential to be predictors of post-laparotomy acute kidney injury. The aim of this study was to investigate the correlation between PI and VIS with the incidence of AKI in post-emergency laparotomy patients in the Intensive Care Unit (ICU).
Design: This cohort study evaluated PI and VIS during and after emergency laparotomy and the incidence of AKI in post-emergency laparotomy patients in the ICU.
Setting: This study was conducted in the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia, from June 2024 to December 2024.
Patients and participants: A total of 30 post-emergency laparotomy patients in the ICU were included in this study.
Measurement and results: The total sample of this study was 30 patients, consisting of 17 patients with AKI. In patients with AKI, the median PI was significantly lower than in patients without AKI (0.85 [0.29-3.76] vs 2.02 [0.34-3.42], p<0.01). Additionally, the median VIS in patients with AKI was significantly higher than in those without AKI (25 [5-55] vs 10 [5-30], p<0.01). Based on the area under the curve (AUC), VIS had a higher predictive value (83.40%) than PI (79.60%). The optimal cut-off for PI was 1.62 (odds ratio [OR] = 10.83 [95% CI: 1.96-59.83], p<0.01), and for VIS was 12.5 (OR=25.66 [95% CI: 3.63-181.43], p<0.01).
Conclusion: A low PI and high VIS are associated with the incidence of post-emergency laparotomy acute kidney injury and might be used as sensitive and specific markers.
Wenny Eka Fidayanti, Syafri Kamsul Arif, Faisal Muchtar, Syamsul Hilal, Haizah Nurdin, Ari Santri Palinrungi
