Preoperative Renal Insufficiency Predicts Postoperative Adverse Outcomes

Study Overview
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Brief Summary
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The main purpose of this study is to evaluate the risk of postoperative mortality and complications in surgical populations with preoperative renal insufficiency.

Detailed Description
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This retrospective cohort study use the National Surgical Quality Improvement Program (NSQIP) database to evaluate the risk of postoperative morbidity and mortality in the surgical population. Patients with estimated. glomerular filtration rate(GFR) < 60 ml/min per 1.73 square meter are defined as the renal insufficiency group. Patients with estimated GFR > 90 ml/min per 1.73 square meter are defined as patients without renal insufficiency. Propensity score-matching methods and multivariate logistic regression are used to calculate the risk of postoperative morbidity and mortality.

Official Title
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Preoperative Renal Insufficiency Predicts Postoperative Adverse Outcomes: A Matched Cohort Study Using the NSQIP Database

Conditions
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Renal Insufficiency, Morality

Intervention / Treatment
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* Diagnostic Test: estimated GFR calculation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with estimated GFR < 60 ml/min per 1.73 square meter or currently on dialysis are included in renal insufficiency group. Patients with estimated GFR > 90 ml/min per 1.73 square meter are included in non-renal insufficiency group Exclusion Criteria: Patients population with estimated GFR between 60-90 is not included in the study
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| renal insufficiency group<br>Surgical population currently on dialysis Surgical population with estimated GFR < 60 ml/min per 1.73 square meter within 90days before the index surgery. The estimated GFR | Diagnostic Test: estimated GFR calculation<br>* The estimated GFR is computed with Modification of Diet in Renal Disease (MDRD) formula<br>|
| Non-renal insufficiency group<br>Defined as the study subjects with eGFR > 90 60 ml/min per 1.73 square meter within 90 days before the index surgery | Diagnostic Test: estimated GFR calculation<br>* The estimated GFR is computed with Modification of Diet in Renal Disease (MDRD) formula<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk of postoperative mortality | Calculate risk of postoperative 30-day in-hospital mortality between groups | 30 days after surgery date | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk of postoperative morbidities | Postoperative events, including pneumonia, septic shock, stroke, deep vein thrombosis/thrombophlebitis, myocardial infarction and postoperative bleeding are included | 30 days after surgery date |