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Unique risks for mortality in patients with end-stage renal disease undergoing nonemergent colorectal surgery
Authors:James J. LiuAdrian Y. Kohut  B.S.  David E. SteinRichard Sensenig  M.S.  M.S.E.E.  Juan L. Poggio
Affiliation:Department of Surgery, Division of Colorectal Surgery, Drexel University College of Medicine, 245 North 15th Street, Suite 7150 NCB, Philadelphia, PA 19102, USA
Abstract:

Background

The aim of this study was to identify unique risk factors for mortality in patients with end-stage renal disease undergoing nonemergent colorectal surgery.

Methods

A multivariate logistic regression model predicting 30-day mortality was constructed for patients with end-stage renal disease undergoing nonemergent colorectal procedures. Data were obtained from the National Surgical Quality Improvement Program (2005–2010).

Results

Among the 394 patients analyzed, those with serum creatinine levels >7.5 mg/dL had .07 times the adjusted mortality risk of those with levels <3.5 mg/dL. For colorectal surgery patients, the average serum creatinine level was 5.52 ± 2.6 mg/dL, and mortality was 13% (n = 50).

Conclusions

High serum creatinine was associated with a lower risk for mortality in patients with end-stage renal disease, even though creatinine is often considered a risk factor for surgery. These results show how variables from a patient-centered subpopulation can differ in meaning from the general population.
Keywords:American College of Surgeons National Surgical Quality Improvement Program   End-stage renal disease   Colorectal surgery   Mortality   Serum creatinine
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