Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction

Hayakawa, Shunsuke; Hayakawa, Tetsushi; Uehara, Shuhei; Miyai, Hirotaka; Ogawa, Ryo; Yamamoto, Masakazu; Tanaka, Moritsugu; Takiguchi, Shuji

doi:10.1111/ases.12931

Cited by 2 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A non-linear correlation between BUN and post-operative 30-day mortality was reported in patients with sepsis ( 11 ). BUN has a predictive value of prognostic risk in laparotomy for strangulated small bowel obstruction ( 12 ) and post-operative stroke risk after cardiac surgical procedures ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Liu

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveThere is limited evidence to clarify the specific relationship between pre-operative blood urea nitrogen (BUN) and post-operative 30-day mortality in patients undergoing craniotomy for tumors. Therefore, we aimed to investigate this relationship in detail.MethodsElectronic medical records of 18,642 patients undergoing craniotomy for tumors in the ACS NSQIP from 2012 to 2015 were subjected to secondary retrospective analysis. The principal exposure was pre-operative BUN. Outcome measures were post-operative 30-day mortality. We used binary logistic regression modeling to evaluate the association between them and conducted a generalized additive model and smooth curve fitting (penalized spline method) to explore the potential relationship and its explicit curve shape. We also conducted sensitivity analyses to ensure the robustness of the results and performed subgroup analyses.ResultsA total of 16,876 patients were included in this analysis. Of these, 47.48% of patients were men. The post-operative 30-day mortality of the included cases was 2.49% (420/16,876), and the mean BUN was 16.874 ± 6.648 mg/dl. After adjusting covariates, the results showed that pre-operative BUN was positively associated with post-operative 30-day mortality (OR = 1.020, 95% CI: 1.004, 1.036). There was also a non-linear relationship between BUN and post-operative 30-day mortality, and the inflection point of the BUN was 9.804. For patients with BUN < 9.804 mg/dl, a 1 unit decrease in BUN was related to a 16.8% increase in the risk of post-operative 30-day mortality (OR = 0.832, 95% CI: 0.737, 0.941); for patients with BUN > 9.804 mg/dl, a 1 unit increase in BUN was related to a 2.8% increase in the risk of post-operative 30-day mortality (OR = 1.028, 95% CI: 1.011, 1.045). The sensitivity analysis proved that the results were robust. The subgroup analysis revealed that all listed subgroups did not affect the relationship between pre-operative BUN and post-operative 30-day mortality (P > 0.05).ConclusionOur study demonstrated that pre-operative BUN (mg/dl) has specific linear and non-linear relationships with post-operative 30-day mortality in patients over 18 years of age who underwent craniotomy for tumors. Proper pre-operative management of BUN and maintenance of BUN near the inflection point (9.804 mg/dl) could reduce the risk of post-operative 30-day mortality in these cases.

show abstract

Section: Introductionmentioning

confidence: 99%

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Liu

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

show abstract

Postoperative pulmonary complications in patients undergoing upper abdominal surgery: risk factors and predictive models

Garg,

Govindaraj,

Dwivedi

et al. 2024

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Postoperative pulmonary complications (PPCs) are unexpected disorders that occur up to 30 days after surgery, affecting the patient’s clinical status and requiring therapeutic intervention. Therefore, it becomes important to assess the patient preoperatively, as many of these complications can be minimized with proper perioperative strategies following a thorough preoperative checkup. Herein, we describe the PPCs and risk factors associated with developing PPCs in patients undergoing upper abdominal surgery. Additionally, we compared the accuracy of the American Society of Anaesthesiologists (ASA) score, the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, the 6-Minute Walk Test (6MWT), and spirometry in predicting PPCs. Consenting patients (>18 years) undergoing elective upper abdominal surgery were recruited from November 2021 to April 2023. Clinical history was noted. Spirometry and 6MWT were both performed. Pre-operative ASA and ARISCAT scores were recorded. Postoperative follow-up was conducted to assess respiratory symptoms and the occurrence of PPC. PPC was defined as per EPCO guidelines. A total of 133 patients were recruited, predominantly male. A total of 27 (20.3%) patients developed PPCs. A total of 14 (10.5%) patients had more than one PPC. The most common PPCs developed were pleural effusion (11.3%), respiratory failure (7.5%), and pneumonia (4.5%). We obtained ten statistically significant associated variables on univariable analysis, viz obstructive airway disease (p=0.002), airflow limitation (p=0.043), chest radiography (p<0.001), albumin (p=0.30), blood urea nitrogen (BUN) (p=0.029), aspartate aminotransferase (p=0.019), alanine aminotransferase (p=0.009), forced expiratory volume in one second/forced vital capacity ratio (p=0.006), duration of surgery (p<0.001), and ASA score (p=0.012). On multivariable regression analysis, abnormal chest radiograph [odds ratio: 8.26; (95% confidence interval: 2.58-25.43), p<0.001], BUN [1.05; (1.00-1.09), p=0.033], and duration of surgery [1.44; (1.18-1.76), p<0.001] were found to be independently associated with PPC. The ASA score was found to have better predictive power for the development of PPCs compared to the ARISCAT score but is of poor clinical significance. Additionally, 6MWD and spirometry results were found to lack any meaningful predictive power for PPC. To conclude, preoperative evaluation of the chest radiograph, BUN, and duration of surgery are independently associated with developing PPCs. The ASA score performs better than the ARISCAT score in identifying patients at a higher risk of developing PPCs and implementing preventive measures.

show abstract

Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction

Cited by 2 publications

References 20 publications

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Postoperative pulmonary complications in patients undergoing upper abdominal surgery: risk factors and predictive models

Contact Info

Product

Resources

About