Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, 2400, Copenhagen, NV, Denmark.
Department of Clinical Biochemistry, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
BMC Surg. 2021 Jan 26;21(1):62. doi: 10.1186/s12893-021-01070-0.
In hospitalized patients, abnormal plasma electrolyte concentrations are frequent and have been linked to poor outcomes following acute surgery. The aim of this study was to assess whether preoperative plasma levels of potassium, sodium, and creatinine at the time of admission were associated with 30-day mortality in patients following open abdominal surgery.
This was a single-center register-based retrospective study. By means of electronic search in a maintained surgery database, all patients (n = 4177) aged ≥ 60 years old undergoing open surgery in our department from January 2000 to May 2013 were identified. Plasma was assessed within 30 days prior to surgery. The primary endpoint was 30-day postoperative mortality. The association between mortality and plasma levels of potassium, sodium, and creatinine were examined using Cox proportional hazard models.
A total of 3690 patients were included in the study cohort. The rates of abnormal preoperative plasma levels were 36, 41, and 38% for potassium, sodium, and creatinine, respectively. The overall 30 day mortality was 20%. A predictive algorithm for 30 day mortality following abdominal surgery was constructed by means of logistic regression showing excellent distinction between patients with and without a fatal postoperative outcome.
Apart from demographic factors (age, sex, and emergency surgery), preoperative imbalance in potassium, sodium and creatinine levels were significant independent predictors of early mortality following open abdominal surgery.
在住院患者中，血浆电解质浓度异常很常见，并且与急性手术后的不良预后相关。本研究旨在评估入院时的钾、钠和肌酐的术前血浆水平是否与开放性腹部手术后 30 天的死亡率相关。
这是一项单中心基于登记的回顾性研究。通过对维持中的外科数据库进行电子搜索，确定了 2000 年 1 月至 2013 年 5 月期间在我院接受开放性手术的所有年龄≥60 岁的患者（n=4177）。在手术前 30 天内评估血浆。主要终点是术后 30 天的死亡率。使用 Cox 比例风险模型检查死亡率与钾、钠和肌酐血浆水平之间的关系。
共有 3690 例患者纳入研究队列。术前血浆异常水平的发生率分别为钾、钠和肌酐的 36%、41%和 38%。总的 30 天死亡率为 20%。通过逻辑回归构建了腹部手术后 30 天死亡率的预测算法，显示出患者之间在致命术后结局方面的出色区分。
除了人口统计学因素（年龄、性别和急诊手术）外，术前钾、钠和肌酐水平失衡是开放性腹部手术后早期死亡率的显著独立预测因素。
