Pubblicazioni

Autori:

Bagante, Fabio; Alaimo, Laura; Tsilimigras, Diamantis; Dalbeni, Andrea; Ejaz, Aslam; Ruzzenente, Andrea; Donadello, Katia; Spolverato, Gaya; Guglielmi, Alfredo; Pawlik, Timothy M

Titolo:

Kidney Disease: Improving Global Outcomes Classification of Chronic Kidney Disease and Short-Term Outcomes of Patients Undergoing Liver Resection

Anno:

2022

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS

ISSN Rivista:

1072-7515

N° Volume:

234

Numero o Fascicolo:

5

Editore:

Attuale :ELSEVIER SCIENCE INC, 360 PARK AVE SOUTH, NEW YORK, USA, NY, 10010-1710 American College of Surgeons:663 North Saint Clair Street:Chicago, IL 60611:(312)202-5000, EMAIL: postmaster@facs.org, INTERNET: http://www.facs.org, Fax: (312)202-5001

Intervallo pagine:

827-839

Parole chiave:

Aged; Female; Glomerular Filtration Rate; Humans; Liver; Male; Postoperative Complications; Retrospective Studies; Risk Factors; Hepatectomy; Renal Insufficiency, Chronic

Breve descrizione dei contenuti:

BACKGROUND: The impact of chronic kidney disease (CKD) on surgery is still not well defined. We sought to characterize the association of preoperative CKD with 30-day mortality after hepatic resection.METHODS: Patients included in the American College of Surgeons (ACS) NSQIP who underwent hepatectomy between 2014 and 2018 were identified. Kidney function was stratified according to the "Kidney Disease: Improving Global Outcomes" (KDIGO) Classification: G1, normal/high function (estimated glomerular-filtration-rate >= 90 ml/min/1.73m(2)); G2-3, mild/moderate CKD (89-30 ml/min/1.73m(2)); G4-5, severe CKD (<= 29 ml/min/1.73m(2)).RESULTS: Overall, 18,321 patients were included. Older patients (ie more than 70 years old) and those with serious medical comorbidities (ie American Society of Anesthesiologists [ASA] class 3) had an increased incidence of severe CKD (both p < 0.001). Patients with G2-3 and G4-5 CKD were more likely to have a prolonged length of stay and to experience postoperative complications (both p < 0.001). Adjusted odds of 30-day mortality increased with the worsening CKD (p = 0.03). The degree of CKD was able to stratify patients within the NSQIP risk calculator. Among patients who underwent major hepatectomy for primary cancer, the rate of 30-day mortality was 2-fold higher with G2-3 and G4-5 CKD vs normal kidney function (p = 0.03).CONCLUSIONS: The degree of CKD was related to the risk of complications and 30-day mortality after hepatectomy. CKD classification should be strongly considered in the preoperative risk estimation of these patients. (C) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

Id prodotto:

130581

Handle IRIS:

11562/1078655

ultima modifica:

23 febbraio 2023

Citazione bibliografica:

Bagante, Fabio; Alaimo, Laura; Tsilimigras, Diamantis; Dalbeni, Andrea; Ejaz, Aslam; Ruzzenente, Andrea; Donadello, Katia; Spolverato, Gaya; Guglielmi, Alfredo; Pawlik, Timothy M, Kidney Disease: Improving Global Outcomes Classification of Chronic Kidney Disease and Short-Term Outcomes of Patients Undergoing Liver Resection «JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS» , vol. 234 , n. 5 , 2022 , pp. 827-839

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