Document Type
Article
Publication Date
9-13-2024
Abstract
BACKGROUND: Chronic kidney disease (CKD) is associated with higher incidence of major surgery. No studies have evaluated the association between preoperative kidney function and postoperative outcomes across a wide spectrum of procedures. We aimed to evaluate the association between CKD and 30-day postoperative outcomes across surgical specialties.
METHODS: We selected adult patients undergoing surgery across eight specialties. The primary study endpoint was major complications, defined as death, unplanned reoperation, cardiac complication, or stroke within 30 days following surgery. Secondary outcomes included Clavien-Dindo high-grade complications, as well as cardiac, pulmonary, infectious, and thromboembolic complications. Multivariable regression was performed to evaluate the association between CKD and 30-day postoperative complications, adjusted for baseline characteristics, surgical specialty, and operative time.
RESULTS: In total, 1,912,682 patients were included. The odds of major complications (adjusted odds ratio [aOR] 2.14 [95% confidence interval (CI): 2.07, 2.21]), death (aOR 3.03 [95% CI: 2.88, 3.19]), unplanned reoperation (aOR 1.57 [95% CI: 1.51, 1.64]), cardiac complication (aOR 3.51 [95% CI: 3.25, 3.80]), and stroke (aOR 1.89 [95% CI: 1.64, 2.17]) were greater for patients with CKD stage 5 vs. stage 1. A similar pattern was observed for the secondary endpoints.
CONCLUSION: This population-based study demonstrates the negative impact of CKD on operative outcomes across a diverse range of procedures and patients.
Recommended Citation
Riveros, Carlos; Ranganathan, Sanjana; Shah, Yash B.; Huang, Emily; Xu, Jiaqiong; Hsu, Enshuo; Geng, Michael; Hu, Siqi; Melchiode, Zachary; Miles, Brian J.; Esnaola, Nestor; Klaassen, Zachary; Jerath, Angela; Wallis, Christopher J.D.; and Satkunasivam, Raj, "Association of Chronic Kidney Disease With Postoperative Outcomes: A National Surgical Quality Improvement Program (NSQIP) Multi-specialty Surgical Cohort Analysis" (2024). Student Papers, Posters & Projects. Paper 147.
https://jdc.jefferson.edu/student_papers/147
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Supplementary Material 1
Language
English
Comments
This article is the author's final published version in BMC Nephrology, Volume 25, 2024, Article number 305.
The published version is available at https://doi.org/10.1186/s12882-024-03753-1. Copyright © The Author(s) 2024.