Treatment of Severe Hyperglycemia in Patients Without Diabetes After Colorectal Surgery

Mannion, John D.; Rather, Assar A.; Gardner, Kelly; McEvilly, Margaret; Fisher, Adrianne; Harper, Lora; Thorogood, Michael; Siegelman, Gary

doi:10.1089/sur.2022.327

Cited by 2 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2017 an early recovery after surgery (ERAS) program was established for elective cases. The cases were managed as previously described [13]. The study was approved by the Bayhealth Institutional Review Board.…”

Section: Methodsmentioning

confidence: 99%

Systemic Inflammation and Acute Kidney Injury After Colorectal Surgery

Mannion,

Rather,

Fisher

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

The relative importance of systemic inflammation among other causes of acute kidney injury (AKI) was investigated in this retrospective review. The WBC on the first postoperative day (POD # 1 WBC) and the derived neutrophil-to-lymphocyte ratio (NLR) were used as measures of inflammation in 1224 consecutive patients undergoing colon procedures. AKI was determined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria and AKI-related complications were documented. Patients without preoperative infection (aseptic population) and the entire population (total population) were examined. AKI occurred in 24.6% of the total population and correlated with complications: postoperative infections (P = 0.016), chronic renal insufficiency (CRI, P < 0.0001), non-infectious complications (P = 0.010), 30-day readmissions (P = 0.001), and length of stay (LOS, P < 0.0001). For the total population, there was a link between inflammation (POD # 1 WBC) and AKI (P = 0.0001), on univariate regression. Medications with anti-inflammatory properties reduced AKI: ketorolac (P = 0.047) and steroids (P = 0.038). Similarly, in an aseptic population, inflammation (POD # 1 NLR) contributed significantly to AKI (P = 0.000). On multivariable analysis, the POD #1 WBC and NLR, were independently associated with AKI (P = 0.000, P = 0.022). Inflammation, in the total or aseptic populations, was a predictor of complications: postoperative infections (P =0.002, P = 0.008), in-hospital complications (P = 0.000, P = 0.002), 30-Day readmissions (P = 0.012, P = 0.371), and LOS (P <0.0001, P = 0.006). Systemic inflammation, whether septic or aseptic, is an important cause of AKI and complications.

show abstract

Section: Methodsmentioning

confidence: 99%

Systemic Inflammation and Acute Kidney Injury After Colorectal Surgery

Mannion,

Rather,

Fisher

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Systemic inflammation and acute kidney injury after colorectal surgery

Mannion,

Rather,

Fisher

et al. 2024

BMC Nephrol

Self Cite

View full text Add to dashboard Cite

Background In this retrospective review, the relative importance of systemic inflammation among other causes of acute kidney injury (AKI) was investigated in 1224 consecutive colorectal surgery patients. A potential benefit from reducing excessive postoperative inflammation on AKI might then be estimated. Methods AKI was determined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The entire population (mixed group), composed of patients with or without sepsis, and a subpopulation of patients without sepsis (aseptic group) were examined. Markers indicative of inflammation were procedure duration, the first postoperative white blood cell (POD # 1 WBC) for the mixed population, and the neutrophil-to-lymphocyte ratio (POD #1 NLR) for the aseptic population. Multivariable logistic regression was then performed using significant (P < 0.05) predictors. The importance of inflammation among independent predictors of AKI and AKI-related complications was then assessed. Results AKI occurred in 24.6% of the total population. For the mixed population, there was a link between inflammation (POD # 1 WBC) and AKI (P = 0.0001), on univariate regression. Medications with anti-inflammatory properties reduced AKI: ketorolac (P = 0.047) and steroids (P = 0.038). Similarly, in an aseptic population, inflammation (POD # 1 NLR) contributed significantly to AKI (P = 0.000). On multivariable analysis for the mixed and aseptic population, the POD #1 WBC and the POD #1 NLR were independently associated with AKI (P = 0.000, P = 0.022), as was procedure duration (P < 0.0001, P < 0.0001). Inflammation-related parameters were the most significant contributors to AKI. AKI correlated with complications: postoperative infections (P = 0.016), chronic renal insufficiency (CRI, P < 0.0001), non-infectious complications (P = 0.010), 30-day readmissions (P = 0.001), and length of stay (LOS, P < 0.0001). Inflammation, in patients with or without sepsis, was similarly a predictor of complications: postoperative infections (P = 0.002, P = 0.008), in-hospital complications (P = 0.000, P = 0.002), 30-day readmissions (P = 0.012, P = 0.371), and LOS (P < 0.0001, P = 0.006), respectively. Conclusions Systemic inflammation is an important cause of AKI. Limiting early postsurgical inflammation has the potential to improve postoperative outcomes.

show abstract

Treatment of Severe Hyperglycemia in Patients Without Diabetes After Colorectal Surgery

Cited by 2 publications

References 21 publications

Systemic Inflammation and Acute Kidney Injury After Colorectal Surgery

Systemic Inflammation and Acute Kidney Injury After Colorectal Surgery

Systemic inflammation and acute kidney injury after colorectal surgery

Contact Info

Product

Resources

About