Predictive factors of acute renal failure in colon and rectal surgery. Academic Article uri icon

Overview

abstract

  • 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.

publication date

  • October 1, 2012

Research

keywords

  • Acute Kidney Injury
  • Colorectal Surgery

Identity

Scopus Document Identifier

  • 84866767060

Digital Object Identifier (DOI)

  • 10.1177/000313481207801001

PubMed ID

  • 23025931

Additional Document Info

volume

  • 78

issue

  • 10