Key result
Preoperative imbalances in potassium, sodium, and creatinine were significant independent predictors of 30-day mortality following open abdominal surgery, with a combined predictive model achieving an area under the curve of 0.80.
Why the study?
Abnormal plasma electrolyte concentrations are frequent in hospitalized patients and linked to poor outcomes after acute surgery, but their association with 30-day mortality after open abdominal surgery required evaluation.
Are preoperative abnormal plasma levels of potassium, sodium, and creatinine associated with increased 30-day mortality in patients aged ≥ 60 years undergoing open abdominal surgery?
Cohort (n=3,690)
No
Are preoperative abnormal plasma levels of potassium, sodium, and creatinine associated with increased 30-day mortality in patients aged ≥ 60 years undergoing open abdominal surgery?
Preoperative electrolyte and creatinine imbalances are significant independent predictors of 30-day mortality in older patients undergoing open abdominal surgery.
Preoperative electrolyte and creatinine imbalances were associated with 30-day mortality after abdominal surgery; hypothesis-generating and requires prospective validation.
BACKGROUND: 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 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. METHODS: This 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. RESULTS: A 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. CONCLUSION: Apart 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.
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Ebrahim et al. (2021) conducted a cohort in Open abdominal surgery (n=3,690). Preoperative abnormal plasma levels of potassium, sodium, and creatinine vs. Normal preoperative plasma levels was evaluated on 30-day postoperative mortality. Preoperative imbalances in potassium, sodium, and creatinine were significant independent predictors of 30-day mortality following open abdominal surgery, with a combined predictive model achieving an area under the curve of 0.80.
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