Abstract
BackgroundIn 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.MethodsThis 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.ResultsA 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.ConclusionApart 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.
Highlights
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 examine if preoperative levels of potassium, sodium, and creatinine were associated with 30-day mortality in adults aged ≥ 60 years undergoing open abdominal surgery including elective and emergency surgery
The patients within the normal ranges had the lowest mortality compared to the patients both below and above the normal ranges whereas mortality increased linearly with increasing levels of creatinine
Summary
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. In order to identify patients at a high risk of postoperative complications and poor outcomes, different scoring systems have been proposed [11, 13,14,15, 17] Most of these require as many as 15–18 variables, e.g. the APACHE II and the P-POSSUM scoring systems, limiting their use in the acute setting [18, 19]. The aim of this study was to examine if preoperative levels of potassium, sodium, and creatinine were associated with 30-day mortality in adults aged ≥ 60 years undergoing open abdominal surgery including elective and emergency surgery. The aim was to develop a predictive algorithm for 30-day mortality
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