Evidence map›Paper›PMID 38818959›Full record

ArticleBJS open2024

Preoperative use of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diuretics increases the risk of dehydration after ileostomy formation: population-based cohort study.

Louise de la Motte, Caroline Nordenvall, Anna Martling, Christian Buchli

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In one paragraph

Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Louise de la MotteDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Caroline NordenvallDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Anna MartlingDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Christian BuchliDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Funding

Cancer Society in StockholmKarolinska InstitutetRegional Agreement on Medical Training and Clinical ResearchRegion StockholmSwedish Cancer and Allergy Foundation (Cancer- och allergifonden)Swedish Cancer Society
6 · The paper itself

Abstract

backgroundReadmission rates following ileostomy formation are high. Dehydration and consecutive renal failure are common causes of readmission, potentially pronounced by drugs affecting the homeostasis. The aim of the study was to assess the risk of dehydration after ileostomy formation in patients treated with angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB) or diuretics.

methodThis nationwide population-based cohort study used data derived from the Colorectal Cancer Data Base of several Swedish healthcare registers. The study included all patients operated on with elective anterior resection and temporary ileostomy for rectal cancer clinically staged I-III in Sweden in 2007-2016. Exposure was at least two dispensations of ACEI, ARB or diuretics within 1 year prior to surgery. Outcome was 90-day readmission due to dehydration including acute renal failure.

resultsIn total, 3252 patients were included with 1173 (36.1%) exposed to ACEI, ARB or diuretics. The cumulative incidence for 90-day readmission due to dehydration was 29.0% (151 of 520) for exposed versus 13.8% (98 of 712) for unexposed. The proportion of readmissions due to any reason was 44.3% (520 of 1173) for exposed compared to 34.2% (712 of 2079) for unexposed. The incidence rate ratio for readmission due to dehydration was 2.83 (95% c.i. 2.21 to 3.63, P < 0.001). The hazard rate ratio was 2.45 (95% c.i. 1.83 to 3.27, P < 0.001) after adjusting for age, gender and comorbidity.

conclusionMedication with ACEI, ARB or diuretics defines a vulnerable patient group with increased risk of readmission due to dehydration after ileostomy formation.

Indexed as

Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsDehydrationDiureticsIleostomyPatient ReadmissionAgedAged, 80 and overCohort StudiesFemaleHumansIncidenceMaleMiddle AgedPostoperative ComplicationsPreoperative CareAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsDiuretics

Identifiers

PMID38818959
PMCPMC11140823

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.