Risk factors for postoperative complications in patients on maintenance hemodialysis who undergo abdominal surgery

• Published in: Asian journal of surgery Vol. 39; no. 4; pp. 211 - 217
• Main Authors: Ito, Tomoaki, Maekawa, Hiroshi, Sakurada, Mutsumi, Orita, Hajime, Kushida, Tomoyuki, Senuma, Koji, Sato, Koichi
• Format: Journal Article
• Language: English
• Published: China Elsevier Taiwan 01.10.2016; Elsevier
• Subjects: Abdomen - surgery; abdominal surgery; Adult; Aged; Aged, 80 and over; complication; Female; Follow-Up Studies; gastrointestinal disease; Gastrointestinal Diseases - surgery; hemodialysis; Humans; maintenance hemodialysis; Male; Middle Aged; Outcome Assessment (Health Care); Postoperative Complications - epidemiology; Postoperative Complications - etiology; Renal Dialysis; Retrospective Studies; Risk Factors; Surgery; hemodialysis; complication; abdominal surgery; gastrointestinal disease; maintenance hemodialysis
• ISSN: 1015-9584; 0219-3108
• DOI: 10.1016/j.asjsur.2015.03.013

Summary Background/Objective Patients on hemodialysis (HD) who undergo abdominal surgery for gastrointestinal disease are at increased risk of postoperative complications. In this study, we retrospectively investigated the predictors of postoperative complications among such patients. Methods The study group comprised 36 HD patients who underwent abdominal surgery for gastrointestinal disease between 2003 and 2012. The clinicopathological factors of the patients who did and did not suffer postoperative complications were compared. Results The overall morbidity and mortality rates were 39% (14/36) and 14% (5/36), respectively. Physical status according to the American Society of Anesthesiologists (ASA) classification ( p  = 0.0203) and intraoperative blood loss ( p  = 0.0013) were found to differ significantly between the groups. Conclusion The morbidity and mortality rates of HD patients who underwent abdominal surgery for gastrointestinal disease were high. Physical status according to the ASA classification and intraoperative blood loss were found to be associated with postoperative complications. Therefore, patients with comorbidities, such as heart disease and diabetes mellitus, have to be treated appropriately before surgery. In addition, it is important that surgeons perform operations carefully and avoid excessive blood loss.