Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries
Abstract Despite a large body of evidence showing the pandemic of chronic kidney disease, the impact of pre-operative kidney function on the risk of post-operative pulmonary complications (PPCs) is not well known. We used multivariable logistic regression analyses with 3-level hierarchical adjustmen...
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Nature Portfolio
2017
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oai:doaj.org-article:335f5b46a50e4da29d9a39c230c6eba32021-12-02T15:05:38ZAssociation of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries10.1038/s41598-017-06842-42045-2322https://doaj.org/article/335f5b46a50e4da29d9a39c230c6eba32017-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-06842-4https://doaj.org/toc/2045-2322Abstract Despite a large body of evidence showing the pandemic of chronic kidney disease, the impact of pre-operative kidney function on the risk of post-operative pulmonary complications (PPCs) is not well known. We used multivariable logistic regression analyses with 3-level hierarchical adjustments to identify the association of pre-operative estimated glomerular filtration rate (eGFR) with PPCs in laparoscopic surgeries. Among 452,213 patients between 2005 and 2013 in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database, a total of 3,727 patients (0.9%) experienced PPCs. We found a gradient association between lower eGFR and higher likelihood of PPCs in the unadjusted model. In the case-mix adjusted model, a reverse-J-shaped association was observed; a small albeit significant association with the highest eGFR category emerged. Further adjustment slightly attenuated these associations, but the PPCs risk in the eGFR groups of <30, 30–60, and ≥120 mL/min/1.73 m2 remained significant: odds ratios (95% confidence intervals) of 1.82 (1.54–2.16), 1.38 (1.24–1.54), and 1.28 (1.07–1.53), respectively (reference: 90–120 mL/min/1.73 m2). Our findings propose a need for careful pre-operative evaluation of cardiovascular and pulmonary functions and post-operative fluid management among patients with not only lower but also very high eGFR.Akihiro ShimomuraYoshitsugu ObiReza Fazl AlizadehShiri LiNinh T. NguyenMichael J. StamosKamyar Kalantar-ZadehHirohito IchiiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017) |
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Medicine R Science Q Akihiro Shimomura Yoshitsugu Obi Reza Fazl Alizadeh Shiri Li Ninh T. Nguyen Michael J. Stamos Kamyar Kalantar-Zadeh Hirohito Ichii Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries |
| description |
Abstract Despite a large body of evidence showing the pandemic of chronic kidney disease, the impact of pre-operative kidney function on the risk of post-operative pulmonary complications (PPCs) is not well known. We used multivariable logistic regression analyses with 3-level hierarchical adjustments to identify the association of pre-operative estimated glomerular filtration rate (eGFR) with PPCs in laparoscopic surgeries. Among 452,213 patients between 2005 and 2013 in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database, a total of 3,727 patients (0.9%) experienced PPCs. We found a gradient association between lower eGFR and higher likelihood of PPCs in the unadjusted model. In the case-mix adjusted model, a reverse-J-shaped association was observed; a small albeit significant association with the highest eGFR category emerged. Further adjustment slightly attenuated these associations, but the PPCs risk in the eGFR groups of <30, 30–60, and ≥120 mL/min/1.73 m2 remained significant: odds ratios (95% confidence intervals) of 1.82 (1.54–2.16), 1.38 (1.24–1.54), and 1.28 (1.07–1.53), respectively (reference: 90–120 mL/min/1.73 m2). Our findings propose a need for careful pre-operative evaluation of cardiovascular and pulmonary functions and post-operative fluid management among patients with not only lower but also very high eGFR. |
| format |
article |
| author |
Akihiro Shimomura Yoshitsugu Obi Reza Fazl Alizadeh Shiri Li Ninh T. Nguyen Michael J. Stamos Kamyar Kalantar-Zadeh Hirohito Ichii |
| author_facet |
Akihiro Shimomura Yoshitsugu Obi Reza Fazl Alizadeh Shiri Li Ninh T. Nguyen Michael J. Stamos Kamyar Kalantar-Zadeh Hirohito Ichii |
| author_sort |
Akihiro Shimomura |
| title |
Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries |
| title_short |
Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries |
| title_full |
Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries |
| title_fullStr |
Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries |
| title_full_unstemmed |
Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries |
| title_sort |
association of pre-operative estimated gfr on post-operative pulmonary complications in laparoscopic surgeries |
| publisher |
Nature Portfolio |
| publishDate |
2017 |
| url |
https://doaj.org/article/335f5b46a50e4da29d9a39c230c6eba3 |
| work_keys_str_mv |
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