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- Title
Complications and Mortality After Surgery in Patients with Chronic Kidney Disease: A Retrospective Cohort Study Based on a Multicenter Clinical Database.
- Authors
Liao, Chien-Chang; Liu, Chih-Chung; Lee, Yuan-Wen; Chang, Chuen-Chau; Yeh, Chun-Chieh; Chang, Tzu-Hao; Chen, Ta-Liang; Lin, Chao-Shun
- Abstract
To evaluate the postoperative complications and mortality among patients with chronic kidney disease. Methods: Biochemical measurements, diagnosis codes for CKD and comorbid conditions for surgical patients aged ≥ 20 years were obtained from electronic medical records of three large hospitals in Taiwan in 2009– 2017. We conducted this retrospective cohort study by using propensity score-matching methods to balance the baseline characteristics between CKD and non-CKD groups. The multiple logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of risks of primary outcome (included postoperative mortality) and secondary outcome (included postoperative infectious complications and non-infectious complications) associated with CKD. Results: Among 31950 eligible surgical patients, the adjusted OR of in-hospital mortality in patients with CKD was 5.49 (95% CI 3.42– 8.81) compared with that in non-CKD controls. The adjusted ORs of postoperative septicemia, pneumonia and cellulitis in patients with CKD were 5.90 (95% CI 2.12– 16.5), 5.39 (95% CI 1.37– 21.16), and 4.42 (95% CI 1.57– 12.4), respectively, when compared with the non-CKD patients. CKD was also associated with postoperative stroke (OR 2.21, 95% CI 1.47– 3.31). Conclusion: Patients with CKD are at increased risk of postoperative stroke, infectious complications, and mortality. Our study implicated that it is crucial to improve the levels of hemoglobin and K+ in patients with CKD before surgery. Preventive strategies should be developed to improve clinical outcomes in these populations.
- Subjects
DENTAL scaling; MULTIPLE regression analysis; LOGISTIC regression analysis; ELECTRONIC health records; CHRONIC kidney failure
- Publication
Journal of Multidisciplinary Healthcare, 2024, Vol 17, p3535
- ISSN
1178-2390
- Publication type
Article
- DOI
10.2147/JMDH.S467613