Risk factors and clinical outcomes for acute kidney injury after surgery for primary spinal and pelvic bone tumours: analysis of the US Nationwide Inpatient Sample 2005 to 2020.

STUDY OBJECTIVE: Primary spinal tumours and pelvic bone tumours are rare but clinically challenging when they arise due to their complex anatomical locations and aggressive behaviour. Surgical resection is first-line treatment but is associated with a high risk of perioperative complications, including acute kidney injury (AKI)-a serious complication with limited evidence in adults undergoing surgery for primary spinal or pelvic bone tumours. This study aimed to evaluate the incidence, risk factors, and outcomes of AKI in adults undergoing surgery for primary spinal or pelvic bone tumours. DESIGN: Retrospective cohort study. SETTING: Nationwide Inpatient Sample (2006-2020). PARTICIPANTS: Adults aged 18 and older who underwent surgery for primary spinal or pelvic bone tumours (identified using ICD-9/10 codes). INTERVENTIONS: Postoperative AKI (observational study) COMPARISONS: AKI MAIN OUTCOME MEASURE(S): Risk factors of postoperative AKI and AKI-associated in-hospital outcomes, including complications, length of stay (LOS), and total hospital charges. RESULTS: A total of 11,712 inpatients were included, representing 57,164 US hospitalisations after weighting. Postoperative AKI incidence was 2.4%. Patients with AKI had significantly longer hospital stays (adjusted β = 10.60 days), higher total hospital charges (adjusted β = $154,890), and increased risk of acute respiratory failure (aOR = 3.81), venous thromboembolism (aOR = 2.81), sepsis (aOR = 5.11), urinary tract infection (aOR = 2.20), and postoperative transfusion (aOR = 2.72) than those without AKI. CONCLUSIONS: Identifying high-risk patients and implementing perioperative kidney-protective strategies might improve outcomes in adults undergoing surgery for primary spinal or pelvic bone tumours.