Drug design, development and therapy · 2026
Perioperative Flurbiprofen Axetil Administration and Acute Kidney Injury After Non-Cardiac Surgery: A Retrospective Cohort Study.
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Wang Shuang, Zhong Yu-Qi, Zhao Bing-Cheng, Hou Xiao-Min, Yin Bin-Yan, Liu Ke-Xuan, Liu Hua-Min
Аннотация
PURPOSE: This study aims to evaluate the impact of different timing of flurbiprofen axetil (FA) administration on postoperative acute kidney injury (AKI) and other adverse events in non-cardiac surgery patients.
PATIENTS AND METHODS: This retrospective cohort study included 45,062 adult patients undergoing non-cardiac surgery from January 1, 2019, to October 31, 2023. Perioperative FA analgesia records were extracted from electronic medical records. The primary outcome was AKI within 7 days after surgery. Secondary outcomes included postoperative adverse cardiovascular events (ACE), postoperative length of stay (LOS), and in-hospital mortality.
RESULTS: The incidences of AKI, ACE, and mortality were 6.0% (2,683/45,062), 8.5% (3,809/45,062), and 0.1% (48/45,062), respectively. Intraoperative [odds ratio (OR), 0.71; 95% confidence interval (CI), 0.62-0.82] and postoperative (OR, 0.73; 95% CI, 0.66-0.79) FA administration was associated with lower odds of AKI compared with non-use. Compared to patients who did not receive FA analgesia at any point, those who received FA both during and post-surgery had a significantly lower odds of AKI (OR, 0.61; 95% CI, 0.51-0.73). Subgroup analysis indicated a greater reduction in AKI odds for intraoperative FA administration in patients with a high inflammatory status (OR and 95% CI: 0.58 [0.47-0.72] vs 0.84 [0.59-1.20], P for interaction = 0.010). Postoperative, but not intraoperative FA administration, was associated with a lower odds of ACE (OR, 0.85; 95% CI, 0.79-0.91), with this association was significant in patients without preoperative hypertension (OR and 95% CI: 0.81 [0.74-0.88] vs 0.96 [0.81-1.13], P for interaction<0.05). Accelerated failure time model showed that both intraoperative and postoperative FA use was inversely correlated with postoperative LOS.
CONCLUSION: Perioperative FA analgesia was associated with a lower odds of postoperative AKI and shorter postoperative LOS, whereas only postoperative FA analgesia was linked to a lower odds of postoperative ACE.
PATIENTS AND METHODS: This retrospective cohort study included 45,062 adult patients undergoing non-cardiac surgery from January 1, 2019, to October 31, 2023. Perioperative FA analgesia records were extracted from electronic medical records. The primary outcome was AKI within 7 days after surgery. Secondary outcomes included postoperative adverse cardiovascular events (ACE), postoperative length of stay (LOS), and in-hospital mortality.
RESULTS: The incidences of AKI, ACE, and mortality were 6.0% (2,683/45,062), 8.5% (3,809/45,062), and 0.1% (48/45,062), respectively. Intraoperative [odds ratio (OR), 0.71; 95% confidence interval (CI), 0.62-0.82] and postoperative (OR, 0.73; 95% CI, 0.66-0.79) FA administration was associated with lower odds of AKI compared with non-use. Compared to patients who did not receive FA analgesia at any point, those who received FA both during and post-surgery had a significantly lower odds of AKI (OR, 0.61; 95% CI, 0.51-0.73). Subgroup analysis indicated a greater reduction in AKI odds for intraoperative FA administration in patients with a high inflammatory status (OR and 95% CI: 0.58 [0.47-0.72] vs 0.84 [0.59-1.20], P for interaction = 0.010). Postoperative, but not intraoperative FA administration, was associated with a lower odds of ACE (OR, 0.85; 95% CI, 0.79-0.91), with this association was significant in patients without preoperative hypertension (OR and 95% CI: 0.81 [0.74-0.88] vs 0.96 [0.81-1.13], P for interaction<0.05). Accelerated failure time model showed that both intraoperative and postoperative FA use was inversely correlated with postoperative LOS.
CONCLUSION: Perioperative FA analgesia was associated with a lower odds of postoperative AKI and shorter postoperative LOS, whereas only postoperative FA analgesia was linked to a lower odds of postoperative ACE.