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*THE IMPACT OF PRE‐OPERATIVE SERUM CREATININE ON SHORT‐TERM OUTCOMES AFTER LIVER RESECTION
Author(s) -
Armstrong T.,
Welsh F. K,
Wells J.,
Chandrakumaran K.,
John T. G.,
Rees M.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04920_4.x
Subject(s) - medicine , creatinine , incidence (geometry) , surgery , renal function , acute kidney injury , kidney , urology , gastroenterology , optics , physics
Background: The aim was to determine whether raised pre‐operative serum creatinine increased the risk of renal failure after liver resection. Method: Data was studied from 1535 consecutive liver resections. Outcomes in patients with normal pre‐operative creatinine (<124 µmol L<συπ>−1) (Group 1) was compared to those with elevated pre‐operative creatinine (>125 µmol L<συπ>−1) (Group 2). Results: The median age of the 1446 (94.3%) patients resected in Group 1 was 62 years compared to 67 years in the 88 (5.7%) in Group 2 (p < 0.0001). Similarly this latter group had double the number of patients who were ASA 3 or 4 (34.1% versus 15.2%, p = 0.00004). Overall, the incidence of post‐operative renal failure requiring haemofiltration was low (0.9%) but significantly more patients in Group 2 (5.7% versus 0.6, p = 0.0007). In addition, patients in Group 2 were more likely to suffer acute kidney injury post‐operatively (18.2% versus 4.3%, p < 0.0001). Although there was no difference in mortality, patients in Group 2 had higher post‐operative morbidity (37.5%) than Group 1 (21.7%, p = 0.0006), with the incidence of cardiorespiratory complications being higher in Group 2 (25.9% versus 8.9%, p = 0.0025). Conclusions: Renal failure following liver resection is rare but patients with an elevated creatinine preoperatively are at increased risk of both renal and non‐renal complications. This information informs both the consent process and provision of post operative care.