Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan.
Department of Surgery, James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Langenbecks Arch Surg. 2024 Aug 6;409(1):240. doi: 10.1007/s00423-024-03434-5.
Dialysis patients are at high risk for surgery, but their outcomes after splenectomy are unclear. We compared postoperative complications between dialysis and non-dialysis patients.
Data were retrieved from the National Surgical Quality Improvement Program for this retrospective cohort. Adult patients undergoing elective splenectomy between 2005 and 2020 were included.
Among 10,339 included patients, 143(1.4%) were on chronic dialysis. Postoperative mortality was higher in dialysis vs. non-dialysis patients (9.1% vs. 1.8%). Dialysis patients were more likely to have 30-day major morbidity, infectious and non-infectious complications, reoperation, and prolonged hospital stay. On multivariable regression, dialysis dependence significantly increased odds of mortality, major morbidity, blood transfusion, prolonged length of stay, reoperation, and failure-to-rescue (FTR).
Dialysis patients were at higher risk of postoperative morbidity following splenectomy. Additionally, the risk of FTR in this patient population is also significantly more compared to non-dialysis patients.
透析患者手术风险较高，但他们的脾切除术术后结果尚不清楚。我们比较了透析和非透析患者的术后并发症。
本回顾性队列研究的数据来自国家手术质量改进计划。纳入 2005 年至 2020 年间择期行脾切除术的成年患者。
在纳入的 10339 例患者中，有 143 例（1.4%）正在接受慢性透析。透析组患者术后死亡率高于非透析组（9.1% vs. 1.8%）。透析患者更有可能在 30 天内出现主要并发症、感染和非感染性并发症、再次手术和住院时间延长。多变量回归分析显示，透析依赖显著增加了死亡率、主要并发症、输血、住院时间延长、再次手术和抢救失败的几率。
透析患者在脾切除术后发生术后并发症的风险更高。此外，与非透析患者相比，该患者人群的抢救失败风险也显著更高。
