TY - JOUR T1 - Intraoperative Hypotension Is Not Correlated With Acute Kidney Injury During Spinal Fusion Surgery JF - International Journal of Spine Surgery JO - Int J Spine Surg SP - 1061 LP - 1067 DO - 10.14444/8367 VL - 16 IS - 6 AU - Rachel Blue AU - Alexis Gutierrez AU - Hasan S. Ahmad AU - Maya Alexis AU - Rachit Kumar AU - Michael Spadola AU - Connor Wathen AU - Mitchell Weinstein AU - Dmitriy Petrov Y1 - 2022/12/01 UR - http://ijssurgery.com//content/16/6/1061.abstract N2 - Background Intraoperative hypotension (IOH) has been found to be associated with organ damage, including cardiac injury and acute kidney injury (AKI). However, to our knowledge, this relationship has not been studied in a neurosurgery-specific patient population. In this report, we review our institutional experience to understand the magnitude of association between IOH in spinal fusion operations and incidence of postoperative AKI.Methods This retrospective cohort study included 910 patients who underwent posterior spinal fusion procedures performed in the prone position. Intraoperative variables collected and analyzed include minute-by-minute mean arterial pressure (MAP) from an arterial catheter, intermittent blood pressure cuff readings, volume of administered intravenous fluids, urine output, and all relevant vitals and administered medications. The electronic medical record was queried for additional patient data. IOH was defined as MAP <65 mm Hg for greater than 10 minutes. The primary endpoints of the study were presence and staging of AKI ( [Kidney Disease: Improving Global Outcomes] consensus classification), postoperative ileus, and postoperative troponin leak.Results Using a partial correlation analysis, no association was found between IOH metrics (IOH occurrence, IOH duration >10 minutes, and total IOH time) and any outcome metrics, including AKI, except for vasopressor usage and estimated blood loss. Patient age at surgery was not associated with any outcome variables. The lack of association between IOH and AKI contrasts with existing literature; this could be due to underlying differences in our patient population or could highlight a more complex relationship between IOH and AKI than previously understood.Conclusion Occurrence and duration of IOH were not associated with AKI, postoperative ileus, troponin leak, length of stay, or any other major outcome variables in spinal fusion patients.Clinical Relevance These findings depart from previous literature showing a correlation between IOH and AKI and provide level 3 evidence clinically relevant to spinal surgery. Further research is needed to better understand the exact nature of this relationship.Level of Evidence 3. ER -