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.

IF 3.5 3区 医学 Q1 SURGERY BJS Open Pub Date : 2024-05-08 DOI:10.1093/bjsopen/zrae051
Louise de la Motte, Caroline Nordenvall, Anna Martling, Christian Buchli
{"title":"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.","authors":"Louise de la Motte, Caroline Nordenvall, Anna Martling, Christian Buchli","doi":"10.1093/bjsopen/zrae051","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Readmission 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.</p><p><strong>Method: </strong>This 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.</p><p><strong>Results: </strong>In 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.</p><p><strong>Conclusion: </strong>Medication with ACEI, ARB or diuretics defines a vulnerable patient group with increased risk of readmission due to dehydration after ileostomy formation.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 3","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11140823/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJS Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjsopen/zrae051","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Readmission 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.

Method: This 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.

Results: In 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.

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

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
术前使用血管紧张素转换酶抑制剂、血管紧张素 II 受体阻滞剂和利尿剂会增加回肠造口术后脱水的风险:基于人群的队列研究。
背景:回肠造口术后的再入院率很高。脱水和连续性肾功能衰竭是再入院的常见原因,影响体内平衡的药物可能会导致脱水和连续性肾功能衰竭。本研究旨在评估使用血管紧张素转换酶抑制剂(ACEI)、血管紧张素 II 受体阻滞剂(ARB)或利尿剂治疗的患者在实施回肠造口术后脱水的风险:这项全国性人群队列研究使用的数据来自瑞典多家医疗保健登记机构的结直肠癌数据库。研究对象包括2007-2016年瑞典所有临床分期为I-III期的直肠癌择期前切除术和临时回肠造口术患者。患者在手术前一年内至少服用过两次 ACEI、ARB 或利尿剂。结果为因脱水(包括急性肾功能衰竭)导致的90天再入院:共纳入 3252 名患者,其中 1173 人(36.1%)使用过 ACEI、ARB 或利尿剂。因脱水导致的 90 天再入院累计发生率为:暴露患者 29.0%(520 例中的 151 例),未暴露患者 13.8%(712 例中的 98 例)。因任何原因再入院的比例,暴露者为 44.3%(1173 例中的 520 例),未暴露者为 34.2%(2079 例中的 712 例)。脱水导致再入院的发病率比为 2.83(95% 置信区间为 2.21 至 3.63,P < 0.001)。调整年龄、性别和合并症后,危险率比为2.45(95% c.i.1.83至3.27,P < 0.001):结论:使用 ACEI、ARB 或利尿剂可确定一个易受伤害的患者群体,其因回肠造口术后脱水而再次入院的风险会增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
期刊最新文献
Classifying histopathological growth patterns for resected colorectal liver metastasis with a deep learning analysis. Short-term outcomes depending on type of oesophagojejunostomy in laparoscopic total gastrectomy for gastric cancer: retrospective study based on a Korean Nationwide Survey for Gastric Cancer in 2019. Association of postoperative opioid type with mortality and readmission rates: multicentre retrospective cohort study. Effects of the superior mesenteric artery approach versus the no-touch approach during pancreatoduodenectomy on the mobilization of circulating tumour cells and clusters in pancreatic cancer (CETUPANC): randomized clinical trial. Reported outcomes in studies of intermittent claudication - first step toward a core outcome set: systematic review.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1