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Abstract：
UNASSIGNED: To evaluate the postoperative complications and mortality among patients with chronic kidney disease.
UNASSIGNED: Biochemical measurements, diagnosis codes for CKD and comorbid conditions for surgical patients aged ≥20 years were obtained from electronic medical records of three large hospitals in Taiwan in 2009-2017. We conducted this retrospective cohort study by using propensity score-matching methods to balance the baseline characteristics between CKD and non-CKD groups. The multiple logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of risks of primary outcome (included postoperative mortality) and secondary outcome (included postoperative infectious complications and non-infectious complications) associated with CKD.
UNASSIGNED: Among 31950 eligible surgical patients, the adjusted OR of in-hospital mortality in patients with CKD was 5.49 (95% CI 3.42-8.81) compared with that in non-CKD controls. The adjusted ORs of postoperative septicemia, pneumonia and cellulitis in patients with CKD were 5.90 (95% CI 2.12-16.5), 5.39 (95% CI 1.37-21.16), and 4.42 (95% CI 1.57-12.4), respectively, when compared with the non-CKD patients. CKD was also associated with postoperative stroke (OR 2.21, 95% CI 1.47-3.31).
UNASSIGNED: Patients with CKD are at increased risk of postoperative stroke, infectious complications, and mortality. Our study implicated that it is crucial to improve the levels of hemoglobin and K+ in patients with CKD before surgery. Preventive strategies should be developed to improve clinical outcomes in these populations.
UNASSIGNED: Biochemical measurements, diagnosis codes for CKD and comorbid conditions for surgical patients aged ≥20 years were obtained from electronic medical records of three large hospitals in Taiwan in 2009-2017. We conducted this retrospective cohort study by using propensity score-matching methods to balance the baseline characteristics between CKD and non-CKD groups. The multiple logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of risks of primary outcome (included postoperative mortality) and secondary outcome (included postoperative infectious complications and non-infectious complications) associated with CKD.
UNASSIGNED: Among 31950 eligible surgical patients, the adjusted OR of in-hospital mortality in patients with CKD was 5.49 (95% CI 3.42-8.81) compared with that in non-CKD controls. The adjusted ORs of postoperative septicemia, pneumonia and cellulitis in patients with CKD were 5.90 (95% CI 2.12-16.5), 5.39 (95% CI 1.37-21.16), and 4.42 (95% CI 1.57-12.4), respectively, when compared with the non-CKD patients. CKD was also associated with postoperative stroke (OR 2.21, 95% CI 1.47-3.31).
UNASSIGNED: Patients with CKD are at increased risk of postoperative stroke, infectious complications, and mortality. Our study implicated that it is crucial to improve the levels of hemoglobin and K+ in patients with CKD before surgery. Preventive strategies should be developed to improve clinical outcomes in these populations.
摘要：
■评估慢性肾脏病患者的术后并发症和死亡率。
■生化测量，2009-2017年,我们从台湾三家大型医院的电子病历中获取了年龄≥20岁手术患者的CKD诊断代码和合并症.我们通过使用倾向评分匹配方法来平衡CKD和非CKD组之间的基线特征，进行了这项回顾性队列研究。多因素logistic回归分析用于估计与CKD相关的主要结局（包括术后死亡率）和次要结局（包括术后感染性并发症和非感染性并发症）风险的比值比（ORs）和95%置信区间（CIs）。
■在31950名合格的手术患者中，与非CKD对照组相比,CKD患者院内死亡率的校正OR为5.49(95%CI3.42~8.81).术后败血症的校正OR，CKD患者的肺炎和蜂窝织炎为5.90（95％CI2.12-16.5），5.39（95%CI1.37-21.16），和4.42（95%CI1.57-12.4），分别,与非CKD患者相比。CKD也与术后卒中相关(OR2.21,95%CI1.47-3.31)。
■CKD患者术后卒中的风险增加，感染并发症,和死亡率。我们的研究表明，改善CKD患者术前血红蛋白和K水平至关重要。应制定预防策略以改善这些人群的临床结果。
■生化测量，2009-2017年,我们从台湾三家大型医院的电子病历中获取了年龄≥20岁手术患者的CKD诊断代码和合并症.我们通过使用倾向评分匹配方法来平衡CKD和非CKD组之间的基线特征，进行了这项回顾性队列研究。多因素logistic回归分析用于估计与CKD相关的主要结局（包括术后死亡率）和次要结局（包括术后感染性并发症和非感染性并发症）风险的比值比（ORs）和95%置信区间（CIs）。
■在31950名合格的手术患者中，与非CKD对照组相比,CKD患者院内死亡率的校正OR为5.49(95%CI3.42~8.81).术后败血症的校正OR，CKD患者的肺炎和蜂窝织炎为5.90（95％CI2.12-16.5），5.39（95%CI1.37-21.16），和4.42（95%CI1.57-12.4），分别,与非CKD患者相比。CKD也与术后卒中相关(OR2.21,95%CI1.47-3.31)。
■CKD患者术后卒中的风险增加，感染并发症,和死亡率。我们的研究表明，改善CKD患者术前血红蛋白和K水平至关重要。应制定预防策略以改善这些人群的临床结果。
