MINS, AKI and Pulmonary Pathology in Patients Undergoing Acute Abdominal Surgery

The main issues are:

* To investigate if coronary calcification predisposes the development of myocardial injury and causes an increased mortality rate.
* To evaluate the predictive value of NT-pro-BNP in relation to the development of MINS and the mortality rate.
* To evaluate the predictive value of different biomarkers of AKI in relation to which patients develop AKI.
* To examine the proteins, exosomes and single cell RNA during acute kidney injury in order to describe the molecular processes in the kidney during AKI.
* To examine whether a chest CT scan without contrast enhancement will change treatment decisions in the acute gastrointestinal patient compared with a chest x-ray.

• Chest CT without contrast enhancement and chest X-ray (Diagnostic test): Chest CT without contrast enhancement and chest X-ray as supplement to diagnostic abdominal CT

Primary outcomes

• Proportion of patients with myocardial injury af non-cardiac surgery [30 days]: Troponin-I above specified level and dynamic changes
• Mortality rate [30 days]: Postoperative mortality
• Mortality rate [90 days]: Postoperative mortality
• Mortality rate [1 year]: Postoperative mortality
• Acute kidney Injury [30 days]: According to KIDGO criteria
• Proportion of patients with pulmonary pathology [1 day]: Findings (including incidental) on a chest x-ray and chest CT scan without contrast enhancement
• Proportion of patients with pulmonary complications [30 days]: Postoperative complications

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adults (≥18 years).
* Patients included in the AHA regimen undergoing CT on suspicion acute high-risk abdominal disorder e.g.g bowel obstruction GI perforation or ischemia, and need of emergency abdominal surgery, either laparoscopic surgery or laparotomy.
* Able to speak Danish. In case Danish was not spoken an interpreter was used to obtain the informed consent.
* Able to give informed consent.

Exclusion Criteria:

* Patients who cannot give informed consent to participate in the study 15 minutes after receiving verbal information regarding the study.
* Known chronic kidney disease requiring dialysis at the time of admission (only exclusion criteria for the part of the study relating to AKI).
* Patients included in the AHA regimen, but conservative treatment is chosen (only exclusion criteria for the part of the study relating to MINS and AKI).
* Patients not resident in Denmark.
* Patients not able to give informed consent.
* Patient not able to speak Danish and not enough time to obtain an interpreter.

• Claus A Bertelsen, PhD, Study chair, Nordsjaellands Hospital