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Acute kidney injury and 1-year mortality after colorectal cancer surgery: A population-based cohort study

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Acute kidney injury and 1-year mortality after colorectal cancer surgery : A population-based cohort study. / Slagelse, Charlotte; Gammelager, Henrik; Iversen, Lene Hjerrild; Sørensen, Henrik Toft; Christiansen, Christian F.

I: BMJ Open, Bind 9, Nr. 3, e024817, 01.03.2019.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{9f92abd5d6d74238a46aefc41d9ebe1a,
title = "Acute kidney injury and 1-year mortality after colorectal cancer surgery: A population-based cohort study",
abstract = "Objectives Acute kidney injury (AKI) is a frequent postoperative complication, but the mortality impact within different postoperative time frames and severities of AKI are poorly understood. We examined the occurrence of postoperative AKI among colorectal cancer (CRC) surgery patients and the impact of AKI on mortality during 1 year after surgery. Design Observational cohort study. We defined the exposure, AKI, as a 50% increase in plasma creatinine or initiation of renal replacement therapy within 7 days after surgery or an absolute increase in creatinine of 26 μmol/L within 48 hours. Setting Population-based Danish medical databases. Participants A total of 6580 patients undergoing CRC surgery in Northern Denmark during 2005-2011 were included from the Danish Colorectal Cancer Group database. Outcomes measure Occurrence of AKI and 8-30, 31-90 and 91-365 days mortality in patient with or without AKI. Results AKI occurred in 1337 patients (20.3%) of the 6580 patients who underwent CRC surgery. Among patients with AKI, 8-30, 31-90 and 91-365 days mortality rates were 10.1% (95% CI 8.6% to 11.9%), 7.8% (95% CI 6.4% to 9.5%) and 12.0% (95% CI 10.3% to 14.2%), respectively. Compared with patients without AKI, AKI was associated with increased 8-30 days mortality (adjusted HR (aHR)=4.01,95% CI 3.11 to 5.17) and 31-90 days mortality (aHR 2.08,95% CI 1.60 to 2.69), while 91-365 days aHR was 1.12 (95% CI 0.89 to 1.41). We observed no major differences in stratified analyses. Conclusions AKI after surgery for CRC is a frequent postoperative complication associated with a substantially increased 90-day mortality. AKI should be considered a potential target for reducing 90-day mortality.",
keywords = "acute kidney injury, colorectal neoplasms, colorectal surgery, mortality, postoperative complications",
author = "Charlotte Slagelse and Henrik Gammelager and Iversen, {Lene Hjerrild} and S{\o}rensen, {Henrik Toft} and Christiansen, {Christian F.}",
year = "2019",
month = mar,
day = "1",
doi = "10.1136/bmjopen-2018-024817",
language = "English",
volume = "9",
journal = "B M J Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "3",

}

RIS

TY - JOUR

T1 - Acute kidney injury and 1-year mortality after colorectal cancer surgery

T2 - A population-based cohort study

AU - Slagelse, Charlotte

AU - Gammelager, Henrik

AU - Iversen, Lene Hjerrild

AU - Sørensen, Henrik Toft

AU - Christiansen, Christian F.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Objectives Acute kidney injury (AKI) is a frequent postoperative complication, but the mortality impact within different postoperative time frames and severities of AKI are poorly understood. We examined the occurrence of postoperative AKI among colorectal cancer (CRC) surgery patients and the impact of AKI on mortality during 1 year after surgery. Design Observational cohort study. We defined the exposure, AKI, as a 50% increase in plasma creatinine or initiation of renal replacement therapy within 7 days after surgery or an absolute increase in creatinine of 26 μmol/L within 48 hours. Setting Population-based Danish medical databases. Participants A total of 6580 patients undergoing CRC surgery in Northern Denmark during 2005-2011 were included from the Danish Colorectal Cancer Group database. Outcomes measure Occurrence of AKI and 8-30, 31-90 and 91-365 days mortality in patient with or without AKI. Results AKI occurred in 1337 patients (20.3%) of the 6580 patients who underwent CRC surgery. Among patients with AKI, 8-30, 31-90 and 91-365 days mortality rates were 10.1% (95% CI 8.6% to 11.9%), 7.8% (95% CI 6.4% to 9.5%) and 12.0% (95% CI 10.3% to 14.2%), respectively. Compared with patients without AKI, AKI was associated with increased 8-30 days mortality (adjusted HR (aHR)=4.01,95% CI 3.11 to 5.17) and 31-90 days mortality (aHR 2.08,95% CI 1.60 to 2.69), while 91-365 days aHR was 1.12 (95% CI 0.89 to 1.41). We observed no major differences in stratified analyses. Conclusions AKI after surgery for CRC is a frequent postoperative complication associated with a substantially increased 90-day mortality. AKI should be considered a potential target for reducing 90-day mortality.

AB - Objectives Acute kidney injury (AKI) is a frequent postoperative complication, but the mortality impact within different postoperative time frames and severities of AKI are poorly understood. We examined the occurrence of postoperative AKI among colorectal cancer (CRC) surgery patients and the impact of AKI on mortality during 1 year after surgery. Design Observational cohort study. We defined the exposure, AKI, as a 50% increase in plasma creatinine or initiation of renal replacement therapy within 7 days after surgery or an absolute increase in creatinine of 26 μmol/L within 48 hours. Setting Population-based Danish medical databases. Participants A total of 6580 patients undergoing CRC surgery in Northern Denmark during 2005-2011 were included from the Danish Colorectal Cancer Group database. Outcomes measure Occurrence of AKI and 8-30, 31-90 and 91-365 days mortality in patient with or without AKI. Results AKI occurred in 1337 patients (20.3%) of the 6580 patients who underwent CRC surgery. Among patients with AKI, 8-30, 31-90 and 91-365 days mortality rates were 10.1% (95% CI 8.6% to 11.9%), 7.8% (95% CI 6.4% to 9.5%) and 12.0% (95% CI 10.3% to 14.2%), respectively. Compared with patients without AKI, AKI was associated with increased 8-30 days mortality (adjusted HR (aHR)=4.01,95% CI 3.11 to 5.17) and 31-90 days mortality (aHR 2.08,95% CI 1.60 to 2.69), while 91-365 days aHR was 1.12 (95% CI 0.89 to 1.41). We observed no major differences in stratified analyses. Conclusions AKI after surgery for CRC is a frequent postoperative complication associated with a substantially increased 90-day mortality. AKI should be considered a potential target for reducing 90-day mortality.

KW - acute kidney injury

KW - colorectal neoplasms

KW - colorectal surgery

KW - mortality

KW - postoperative complications

UR - http://www.scopus.com/inward/record.url?scp=85062921344&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2018-024817

DO - 10.1136/bmjopen-2018-024817

M3 - Journal article

C2 - 30872545

AN - SCOPUS:85062921344

VL - 9

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 3

M1 - e024817

ER -