Perioperative Myocardial Injury and Acute Kidney Injury in Patients Undergoing Hepatic Resection: Incidence, Risk Factors, and Effects on Outcomes

<b>Background/Objectives:</b> Perioperative organ injury (POI) is frequently observed following hepatectomy as acute kidney injury (AKI), perioperative myocardial injury (PMI), or both. We aimed to determine the incidences of POI, PMI, and AKI, reveal the risk factors and predictive tools for POI occurrence, and evaluate the relationship between POI and patient outcomes. <b>Methods:</b> This was a single-center historical cohort study of consecutive patients. The primary endpoint was the occurrence of POI within 3 days following hepatectomy. <b>Results:</b> Out of 128 patients, POI, PMI, and AKI occurred in 48 (37.5%), 36 (28.1%), and 23 (18%) patients, respectively. Ten (7.8%) patients suffered from both PMI and AKI. The presence of chronic kidney disease or systolic/valvular heart disease, fluid balance more than 365 mL/h, and intraoperative bleeding more than 950 mL were the risk factors for POI. A tool created by using the intraoperative decline of central venous oxygen saturation and lactate value during skin closure performed well in predicting POI (area under the ROC curve: 0.79, <i>p</i> < 0.001). In patients with POI, the number of those who needed intensive care unit (ICU) follow-up for more than 1 day was significantly higher (21% vs. 6%, <i>p</i>: 0.01). The length of hospital stay for these patients was significantly longer as well (11 (8-18) vs. 9 (7-13) days, <i>p</i>: 0.02). Two patients (20% of 10 patients who suffered from both AKI and PMI) died in the 90-day follow-up. <b>Conclusions:</b> POI is a common complication following hepatectomy and is associated with longer hospital and ICU stays. Patients who suffer from both AKI and PMI have a higher risk of mortality.