Show simple item record

Enhanced recovery protocols for colorectal surgery and postoperative renal function: a retrospective review.

dc.contributor.author Adam, MA
dc.contributor.author Grant, Stuart Alan
dc.contributor.author Horres, C Russell III
dc.contributor.author Miller, Timothy Ellis
dc.contributor.author Moon, Richard Edward
dc.contributor.author Sun, Zhifei
dc.contributor.author Thacker, Julie K Marosky
dc.coverage.spatial England
dc.date.accessioned 2017-11-01T13:28:51Z
dc.date.available 2017-11-01T13:28:51Z
dc.date.issued 2017
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/28948012
dc.identifier 69
dc.identifier.issn 2047-0525
dc.identifier.uri https://hdl.handle.net/10161/15693
dc.description.abstract BACKGROUND: While enhanced recovery protocols (ERPs) reduce physiologic stress and improve outcomes in general, their effects on postoperative renal function have not been directly studied. METHODS: Patients undergoing major colorectal surgery under ERP (February 2010 to March 2013) were compared with a traditional care control group (October 2004 October 2007) at a single institution. Multivariable regression models examined the association of ERP with postoperative creatinine changes and incidence of postoperative acute kidney dysfunction (based on the Risk, Injury, Failure, Loss, and End-stage renal disease criteria). RESULTS: Included were 1054 patients: 590 patients underwent surgery with ERP and 464 patients without ERP. Patient demographics were not significantly different. Higher rates of neoplastic and inflammatory bowel disease surgical indications were found in the ERP group (81 vs. 74%, p = 0.045). Patients in the ERP group had more comorbidities (ASA ≥ 3) (62 vs. 40%, p < 0.001). In unadjusted analysis, postoperative creatinine increase was slightly higher in the ERP group compared with control (median 0.1 vs. 0 mg/dL, p < 0.001), but levels of postoperative acute kidney injury were similar in both groups (p = 0.998). After adjustment with multivariable regression, postoperative changes in creatinine were similar in ERP vs. control (p = 0.25). CONCLUSIONS: ERP in colorectal surgery is not associated with a clinically significant increase in postoperative creatinine or incidence of postoperative kidney injury. Our results support the safety of ERPs in colorectal surgery and may promote expanding implementation of these protocols. TRIAL REGISTRATION: Not applicable, prospective data collection and retrospective chart review only.
dc.language eng
dc.relation.ispartof Perioper Med (Lond)
dc.relation.isversionof 10.1186/s13741-017-0069-0
dc.subject Enhanced recovery
dc.subject Goal-directed fluid therapy
dc.subject Perioperative acute kidney injury
dc.subject RIFLE criteria
dc.title Enhanced recovery protocols for colorectal surgery and postoperative renal function: a retrospective review.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/28948012
pubs.begin-page 13
pubs.organisational-group Anesthesiology
pubs.organisational-group Anesthesiology, General, Vascular, High Risk Transplant & Critical Care
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group School of Medicine
pubs.organisational-group Staff
pubs.organisational-group Surgery
pubs.organisational-group Surgery, Advanced Oncologic and Gastrointestinal Surgery
pubs.publication-status Published online
pubs.volume 6


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record