Abstract:
Introduction: Post-operative AKI is not an uncommon complication following vascular surgery and it’s linked to poorer outcomes and longer hospital stay. The VSKIPS tool predicts risk factors for AKI (older age, low eGFR, emergency surgery, preoperative diuretics and beta blockers, previous vascular intervention and hypertension). This study aimed to validate VSKIPS in our local population and identify any additional risk factors to enhance preoperative assessment and improve patient's outcome.
Methods: We conducted a retrospective cohort study of 100 randomly selected vascular surgery patients at a UK tertiary hospital from 2022-2024. Patients were divided into two postoperative groups: 50 who developed AKI 2 or above and 50 who did not develop AKI. There were no statistically significant differences between groups. Data were collected from electronic health records. Statistical analysis was performed using SPSS. Chi-squared and T-tests were used to compare groups.
Results: Diabetes mellitus, emergency surgery, perioperative beta-blocker use, and low perioperative
eGFR were significantly associated with postoperative AKI in our cohort (P<0.001). Interestingly, traditional predictors like older age (P = 0.8), hypertension(P=0.069), nephrotoxic drug exposure (P=0.41), and prior vascular procedures(P=0.78) did not show statistical significance, contrary to VSKIPS study. Our findings suggest the addition of diabetes as an important independent risk factor in our patient population.
Conclusion: Our study validates key components of the VSKIPS and recognises diabetes as a major risk
factor in developing AKI. Enhancing proactive preoperative risk assessment, risk factor optimisation, and a multidisciplinary approach is recommended to prevent AKI in vascular surgical patients.
