Department of Surgery, Pennsylvania State University, College of Medicine, Hershey Medical Center, Hershey, PA 17033, USA.
Surgery. 2012 Oct;152(4):537-47; discussion 547-9. doi: 10.1016/j.surg.2012.07.003. Epub 2012 Aug 26.
It is unknown how colorectal surgical outcomes in recipients of renal transplants (TXP) compare to the outcomes in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD).
Data from the Nationwide Inpatient Sample for 2004 to 2008 were reviewed. International Classification of Diseases (ICD-9) codes identified patients undergoing colorectal surgery who were stratified as having no kidney disease, CKD, ESRD, or TXP. The effects of renal status on mortality, length of hospital stay, and hospital costs were determined.
A total of 171,133 patients were identified; 162,986 had no kidney disease, 3,686 had CKD, 1,296 had ESRD, and 3,765 had had TXP. The odds of death after surgery were 43% more likely for patients with CKD, 82% more likely for TXP, and 240% more likely for those with ESRD. TXP resulted in an additional length of hospital stay of 3.4 days, compared to 3.2 days for those with ESRD, and 1.1 days for those with CKD (P < .0001). CKD added $4,223 in additional costs, TXP added $8,213, and ESRD added $12,821 (P < .0001). TXP demonstrated odds of mortality between those of CKD and ESRD for cardiovascular complications (OR 2.47). Pulmonary complications resulted in the highest odds of mortality for TXP (OR 6.3).
After TXP, patients undergoing colorectal surgery have mortality and costs between those of patients with CKD and ESRD, with pulmonary complications remaining high mortality events.
接受肾移植（TXP）的结直肠手术患者的结局与慢性肾脏病（CKD）和终末期肾病（ESRD）患者的结局相比如何，目前尚不清楚。
回顾了 2004 年至 2008 年全国住院患者样本的数据。国际疾病分类（ICD-9）代码确定了接受结直肠手术的患者，这些患者分为无肾病、CKD、ESRD 或 TXP。确定了肾功能对死亡率、住院时间和住院费用的影响。
共确定了 171133 例患者；162986 例无肾病，3686 例 CKD，1296 例 ESRD，3765 例 TXP。CKD 患者术后死亡的可能性增加 43%，TXP 患者增加 82%，ESRD 患者增加 240%。与 ESRD 患者的 3.2 天相比，TXP 患者的住院时间延长了 3.4 天，而 CKD 患者的住院时间延长了 1.1 天（P <.0001）。CKD 增加了 4223 美元的额外费用，TXP 增加了 8213 美元，ESRD 增加了 12821 美元（P <.0001）。TXP 在心血管并发症方面的死亡率介于 CKD 和 ESRD 之间（OR 2.47）。肺部并发症导致 TXP 死亡率最高（OR 6.3）。
在 TXP 后，接受结直肠手术的患者的死亡率和费用介于 CKD 和 ESRD 患者之间，肺部并发症仍然是高死亡率事件。
