Postoperative complications among dialysis-requiring patients undergoing splenectomy.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2024-08-06 DOI:10.1007/s00423-024-03434-5

Usama Waqar, Rana Muhammad Ahmed Mudabbir, Meher Angez, Kaleem Sohail Ahmed, Daniyal Ali Khan, Muhammad Shahzaib Arshad, Hasnain Zafar

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Abstract

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.

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接受脾脏切除术的需要透析的患者的术后并发症。

背景：透析患者是手术的高危人群，但他们在脾脏切除术后的预后尚不明确。我们比较了透析患者和非透析患者的术后并发症：方法：我们从国家外科手术质量改进计划中获取数据，进行回顾性队列研究。纳入了 2005 年至 2020 年间接受择期脾切除术的成人患者：在10339名纳入患者中，有143人（1.4%）接受了慢性透析。透析患者的术后死亡率高于非透析患者（9.1% 对 1.8%）。透析患者更有可能出现 30 天的主要发病率、感染性和非感染性并发症、再次手术和住院时间延长。在多变量回归中，透析依赖会显著增加死亡率、主要发病率、输血、住院时间延长、再次手术和抢救失败（FTR）的几率：结论：透析患者在脾切除术后发病的风险较高。结论：与非透析患者相比，透析患者在脾脏切除术后发病的风险更高，而且发生 FTR 的风险也更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.