Back to Search Start Over

Preoperative dehydration increases risk of postoperative acute renal failure in colon and rectal surgery.

Authors :
Moghadamyeghaneh Z
Phelan MJ
Carmichael JC
Mills SD
Pigazzi A
Nguyen NT
Stamos MJ
Source :
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2014 Dec; Vol. 18 (12), pp. 2178-85. Date of Electronic Publication: 2014 Sep 20.
Publication Year :
2014

Abstract

Objectives: There is limited data regarding the effects of preoperative dehydration on postoperative renal function. We sought to identify associations between hydration status before operation and postoperative acute renal failure (ARF) in patients undergoing colorectal resection.<br />Methods: The NSQIP database was used to examine the data of patients undergoing colorectal resection from 2005 to 2011. We used preoperative blood urea nitrogen (BUN)/creatinine ratio >20 as a marker of relative dehydration. Multivariate analysis using logistic regression was performed to quantify the association of BUN/Cr ratio with ARF.<br />Results: We sampled 27,860 patients who underwent colorectal resection. Patients with dehydration had higher risk of ARF compared to patients with BUN/Cr <10 (AOR, 1.23; P = 0.04). Dehydration was associated with an increase in mortality of the affected patients (AOR, 2.19; P < 0.01). Postoperative complication of myocardial infarction (MI) (AOR, 1.46; P < 0.01) and cardiac arrest (AOR, 1.39; P < 0.01) was higher in dehydrated patients. Open colorectal procedures (AOR, 2.67; P = 0.01) and total colectomy procedure (AOR, 1.62; P < 0.01) had associations with ARF.<br />Conclusion: Dehydration before operation is a common condition in colorectal surgery (incidence of 27.7 %). Preoperative dehydration is associated with increased rates of postoperative ARF, MI, and cardiac arrest. Hydrotherapy of patients with dehydration may decrease postoperative complications in colorectal surgery.

Details

Language :
English
ISSN :
1873-4626
Volume :
18
Issue :
12
Database :
MEDLINE
Journal :
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Publication Type :
Academic Journal
Accession number :
25238816
Full Text :
https://doi.org/10.1007/s11605-014-2661-7