Postoperative complications among dialysis-requiring patients undergoing splenectomy.

Autor: Waqar U; Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan. usama.waqar@scholar.aku.edu.; Department of Surgery, James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA. usama.waqar@scholar.aku.edu., Mudabbir RMA; Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan., Angez M; Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan., Ahmed KS; Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA., Khan DA; Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan., Arshad MS; Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan., Zafar H; Section of General Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2024 Aug 06; Vol. 409 (1), pp. 240. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.1007/s00423-024-03434-5
Abstrakt: Background: Dialysis patients are at high risk for surgery, but their outcomes after splenectomy are unclear. We compared postoperative complications between dialysis and non-dialysis patients.
Methods: Data were retrieved from the National Surgical Quality Improvement Program for this retrospective cohort. Adult patients undergoing elective splenectomy between 2005 and 2020 were included.
Results: Among 10,339 included patients, 143(1.4%) were on chronic dialysis. Postoperative mortality was higher in dialysis vs. non-dialysis patients (9.1% vs. 1.8%). Dialysis patients were more likely to have 30-day major morbidity, infectious and non-infectious complications, reoperation, and prolonged hospital stay. On multivariable regression, dialysis dependence significantly increased odds of mortality, major morbidity, blood transfusion, prolonged length of stay, reoperation, and failure-to-rescue (FTR).
Conclusion: Dialysis patients were at higher risk of postoperative morbidity following splenectomy. Additionally, the risk of FTR in this patient population is also significantly more compared to non-dialysis patients.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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