Association of dialysis with adverse postoperative outcomes in XXXX -an analysis of ACS-NSQIP.

@entity1 @entity295 @entity55 @entity5 @entity326 @entity281 @entity358 @entity14
PURPOSE: Dialysis is an important factor in predicting the risk associated with cardiovascular and general abdominal surgery. The association between @entity5 @entity1 and dialysis was also studied, and in particular, the effects of dialysis on the postoperative outcomes of @entity14 which has not been widely reported in the literature. METHODS: This is a retrospective, multi-institutional study of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database, investigating preoperative dialysis status and its association with postoperative mortality and morbidity. RESULTS: Among 42,403 @entity14 @entity1 , 265 @entity1 (0.6 %) were receiving dialysis. @entity1 undergoing dialysis had a higher risk of re-intubation (6.8 %, p   <   0.001), on ventilator-support more than 48 h (7.2 %, p   <   0.001), and @entity295 (7.2 %, p   <   0.05). Deep @entity281 (adjusted odds ratio   =   2.09), @entity55 (adjusted odds ratio   =   1.86), and @entity326 (adjusted odds ratio   =   1.9) were significantly associated with dialysis status. The postoperative mortality rate of dialysis @entity1 was 8.3 % (p   <   0.001) and had significant association in a multivariate Cox proportional hazard model (hazard ratio   =   1.63, p   =   0.026). Total length of hospital stay (coefficient   =   3.5, p   <   0.001) and overall complication (coefficient   =   0.134, p   <   0.001) were prominent in the dialysis groups. The rate of laparoscopic surgery in dialysis and non-dialysis @entity1 was 33 and 42 %, respectively (odds ratio   =   0.693, p   =   0.005). CONCLUSIONS: In @entity14 , dialysis status significantly contributes to postoperative morbidity, length of total hospital stay, and mortality. In addition, the rates of preventable @entity358 were shown to require more careful attention in the hospital setting, and particularly in dialysis @entity1 . Preoperative dialysis @entity1 are less likely than non-dialysis @entity1 to undergo a minimally invasive approach.
