ArticleDiseases of the colon and rectum2016
Colorectal Surgery Outcomes in Chronic Dialysis Patients: An American College of Surgeons National Surgical Quality Improvement Program Study.
Article in Diseases of the colon and rectum, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 18 citations in OpenAlex.
- Impact of a minimally invasive approach for colon cancer surgery on outcomes in patients with functional limitations.Colorectal cancer · 2025Article
- Comparative analysis of short- and long-term outcomes in laparoscopic versus open surgery for colorectal cancer patients undergoing hemodialysis.Langenbeck's archives of surgery · 2024Article
- Maximizing Readmission Reduction in Colon Cancer Patients.The Journal of surgical research · 2024Article
- Real-world survival after colorectal surgery for malignancy in Korean patients with chronic kidney disease: an analysis of Korean healthcare big data, 2002-2019.Annals of surgical treatment and research · 2023Article
- Effect of preoperative asymptomatic renal dysfunction on the clinical course after colectomy for colon cancer.Surgery today · 2022Article
- Comparisons of postoperative outcomes after breast cancer surgery in patients with and without renal replacement therapy: a matched-pair cohort study using a Japanese nationwide inpatient database.Breast cancer (Tokyo, Japan) · 2021Article
- Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study.World journal of emergency surgery : WJES · 2020Article
- Increased 30-Day Mortality Risk in Patients With Diabetes Mellitus After Colon Cancer Surgery: A Mediation Analysis.Diseases of the colon and rectum · 2020Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMore than 450,000 US patients with end-stage renal disease currently dialyze. The risk of morbidity and mortality for these patients after colorectal surgery has been incompletely described.
objectiveWe analyzed the 30-day morbidity and mortality rates of chronic dialysis patients who underwent colorectal surgery.
designThis was a retrospective analysis. SETTINGS: Hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program were included. PATIENTS: The study included adult patients who underwent emergency or elective colon or rectal resection between 2009 and 2014.
main outcome measuresBaseline characteristics were compared by dialysis status. The impact of chronic dialysis on 30-day mortality and serious postoperative morbidity was examined using multivariate logistic regression.
resultsWe identified 128,757 patients who underwent colorectal surgery in the American College of Surgeons National Surgical Quality Improvement Program database. Chronic dialysis patients accounted for 1% (n = 1285) and were more likely to be older (65.4 vs 63.2 years; p < 0.0001), black (27.2% vs 8.7%; p < 0.0001), preoperatively septic (22.1% vs 7.1%; p < 0.0001), require emergency surgery (52.0% vs 14.7%; p < 0.0001), have ischemic bowel (15.7% vs 1.6%; p < 0.0001), or have perforation/peritonitis (15.5% vs 4.2%; p < 0.0001). Chronic dialysis patients were also less likely to have a laparoscopic procedure (17.3% vs 45.0%; p < 0.0001). Chronic dialysis patients had higher unadjusted mortality (22.4% vs 3.3%; p < 0.0001), serious postoperative morbidity (47.9% vs 18.8%; p < 0.0001), and median length of stay (9 vs 6 days; p < 0.0001). In emergent cases (n = 19,375), multivariate logistic regression models demonstrated a higher risk of mortality for dialysis patients (OR = 1.73 (95% CI, 1.38-2.16)) but not for serious morbidity. Models for elective surgery demonstrated a similar effect on mortality (OR = 2.47 (95% CI, 1.75-3.50)) but also demonstrated a higher risk of serious morbidity (OR = 1.28 (95% CI, 1.04-1.56)). LIMITATIONS: The postoperative 30-day window may underestimate the true incidence of serious morbidity and mortality.
conclusionsChronic dialysis patients undergoing elective or emergent colorectal procedures have a higher risk-adjusted mortality.
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