Postoperative complications among dialysis-requiring patients undergoing splenectomy

Langenbecks Arch Surg. 2024 Aug 6;409(1):240. doi: 10.1007/s00423-024-03434-5.

Abstract

Background: Dialysis patients are at high risk for surgery, but their outcomes after splenectomy are unclear. We compared postoperative complications between dialysis and non-dialysis patients.

Methods: Data were retrieved from the National Surgical Quality Improvement Program for this retrospective cohort. Adult patients undergoing elective splenectomy between 2005 and 2020 were included.

Results: Among 10,339 included patients, 143(1.4%) were on chronic dialysis. Postoperative mortality was higher in dialysis vs. non-dialysis patients (9.1% vs. 1.8%). Dialysis patients were more likely to have 30-day major morbidity, infectious and non-infectious complications, reoperation, and prolonged hospital stay. On multivariable regression, dialysis dependence significantly increased odds of mortality, major morbidity, blood transfusion, prolonged length of stay, reoperation, and failure-to-rescue (FTR).

Conclusion: Dialysis patients were at higher risk of postoperative morbidity following splenectomy. Additionally, the risk of FTR in this patient population is also significantly more compared to non-dialysis patients.

Keywords: Dialysis; End-stage renal disease; Splenectomy; Surgery.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Postoperative Complications* / mortality
  • Renal Dialysis*
  • Retrospective Studies
  • Splenectomy* / adverse effects