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Predictive factors of acute renal failure in colon and rectal surgery.
MedLine Citation:
PMID:  23025931     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Postoperative acute renal failure (ARF) is a major factor of morbidity and mortality in colon and rectal surgery. The objectives of this study were: 1) to determine the frequency of ARF in colorectal surgery; and 2) to evaluate the impact of patient characteristics, comorbidities, resection type, pathology, surgical technique, and admission type on ARF. Using the National Inpatient Sample database, we examined the clinical data of patients who underwent colon and rectal resection from 2006 to 2008. A total of 975,825 patients underwent colorectal resection during this period. Overall, the rate of ARF was 7.41 per cent (elective surgery: 3.38% vs emergent surgery: 12.99% ; P < 0.01). Using multivariate regression analysis, chronic renal failure (adjusted odds ratio [AOR], 5.37), emergent operation (AOR, 2.64), total colectomy (AOR, 2.61), age 65 years or older (AOR, 2.02), liver disease (AOR, 1.82), congestive heart failure (AOR, 1.81), alcohol abuse (AOR, 1.67), peripheral vascular disease (AOR, 1.50), obesity (AOR, 1.45), malignant tumor (AOR, 1.44), open operation (AOR, 1.37), male sex (AOR, 1.37), left colectomy (AOR, 1.32), black race (AOR, 1.22), and teaching hospital (AOR, 1.05) were associated with higher risk of ARF. There was no association between hypertension, diabetes, chronic lung disease, smoking, transverse colectomy, proctectomy, diverticulitis, ulcerative colitis, or Crohn's disease and ARF. Chronic renal failure, emergent operation, total colectomy and age 65 years or older are potent independent predictors of ARF. In high-risk circumstances, specific care should be taken to prevent renal insults.
Authors:
Hossein Masoomi; Joseph C Carmichael; Matthew Dolich; Steven Mills; Noor Ketana; Alessio Pigazzi; Michael J Stamos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  78     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1019-23     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of California, Irvine, Medical Center, Orange, California, USA.
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