Risk factors and outcomes of renal insufficiency after colectomy for diverticulitis.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Techniques in Coloproctology Pub Date : 2024-12-12 DOI:10.1007/s10151-024-03063-6

J K Elsawwah, J S Flanagan, P B Stopper, R H Rolandelli, Z H Nemeth

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Abstract

Background: Diverticulitis has significantly increased in prevalence in recent decades, requiring higher rates of colon resections. While current literature focuses on postoperative complications such as abscesses, wound infections, and anastomotic leaks, many are limited in showing details regarding the significant risk associated with developing renal insufficiency among diverticulitis patients undergoing colectomy.

Methods: We selected patients from the 2022 National Surgical Quality Improvement Program (NSQIP) Colectomy database who underwent colon resection for diverticulitis using International Classification of Disease (ICD10) code K57.92. To analyze postoperative renal function, we removed all patients with preoperative renal failure. From there, a total of 6985 patients with no postoperative renal insufficiency (Control group) and 492 with postoperative renal insufficiency (Post-op. RI group) were identified.

Results: Of individuals undergoing colectomy for diverticulitis, 6.58% experienced postoperative renal insufficiency. In all diverticulitis colectomies, comorbidities such as diabetes (21.95% versus 10.95%; p = 0.018), congestive heart failure (11.59% versus 2.95% p < 0.001), hypertension (61.79% versus 42.83%; p < 0.001), and chronic obstructive pulmonary disease (9.96% versus 3.66%; p < 0.001) were associated with higher risk of kidney injury. Multivariate regression analysis indicated that postoperative renal insufficiency is independently associated with increased risk of mortality (odds ratio = 3.8001; p < 0.001).

Conclusions: As the prevalence of diverticulitis has increased in the USA, it is paramount to recognize the risks associated with the required operation as well as the factors that affect patient outcomes and risks for developing renal insufficiency.

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憩室炎结肠切除术后肾功能不全的危险因素和结局。

背景：近几十年来，憩室炎的患病率显著增加，需要更高的结肠切除术率。虽然目前的文献关注的是术后并发症，如脓肿、伤口感染和吻合口渗漏，但许多文献对结肠切除术后憩室炎患者发生肾功能不全的重要风险的详细描述有限。方法：我们从2022年国家外科质量改进计划（NSQIP）结肠切除术数据库中选择使用国际疾病分类（ICD10）代码K57.92进行憩室炎结肠切除术的患者。为了分析术后肾功能，我们移除了所有术前肾功能衰竭的患者。术后无肾功能不全患者6985例（对照组），术后肾功能不全患者492例（术后）。RI组)。结果：在因憩室炎行结肠切除术的患者中，6.58%的患者出现了术后肾功能不全。在所有憩室炎结肠中，合并症如糖尿病(21.95% vs 10.95%；p = 0.018)，充血性心力衰竭（11.59%对2.95% p）。结论：随着美国憩室炎患病率的增加，认识到与所需手术相关的风险以及影响患者预后和发生肾功能不全风险的因素至关重要。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.