Even minor alteration of plasma creatinine after open abdominal surgery is associated with 30-day mortality: A single-centre cohort study - 19/11/21
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Highlights |
• | This study investigates data from 3,460 patients undergoing open abdominal surgery. |
• | Minor daily postoperative p-creatinine increase is associated with elevated 30-day mortality risk. |
• | After elective surgery, postoperative p-creatinine increase is associated with nearly a 30-fold risk of 30-day mortality. |
• | Male patients and patients with advanced age are particularly at higher risk of 30-day mortality after postoperative increase of p-creatinine. |
Summary |
Purpose |
Postoperative acute kidney injury is common and associated with increased length of hospital stay, costs and mortality. The impact from postoperative subclinical changes in plasma concentration of creatinine (p-creatinine) on postoperative mortality has received less attention. In this study, the association between the postoperative change of p-creatinine and all-cause mortality was investigated.
Methods |
A single-centre register-based, retrospective study was conducted including patients ≥60 years undergoing open abdominal surgery from 2000 to 2013. Postoperative p-creatinine change was analysed for association with 30-day mortality following adjustment for age, gender, surgical setting and surgical procedure.
Main findings A total of 3,460 patients were included in the study of whom 67.6% underwent emergency surgery. The 30-day mortality rate was 18.3%, and a given 10μmol/L daily postoperative increase in p-creatinine was associated with an increased mortality risk with an odds ratio (OR) of 2.67 (95% CI; 2.28-3.14, P<0.001). In patients undergoing emergency surgery, a daily 10μmol/L increase in p-creatinine increased the risk for a fatal outcome a 2.39 OR (CI 95%; 2.05-2.78), P<0.001). In patients undergoing elective surgery, a similar increase in p-creatinine increased risk of postoperative death with a 28.85 OR (CI 95%; 10.25-81.19).
Conclusion |
Even a minor postoperative p-creatinine increase following open abdominal surgery below the criteria for acute kidney injury was associated with increased 30-day mortality in patients aged 60 years or above.
El texto completo de este artículo está disponible en PDF.Keywords : Abdominal surgery, Mortality, Creatinine, Renal insufficiency, Acute kidney injury
Esquema
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