Resumo

MARTINEZ-MIER, Gustavo et al. Morbidity and mortality after surgery in patients undergoing dialysis: cases and controls study. Cir. gen [online]. 2011, vol.33, n.4, pp.227-231. ISSN 1405-0099.

Objective: To describe our surgical experience with patients undergoing dialysis, addressing the identification of perioperative (30 days) risk factors for morbidity and mortality. Setting: CMN Adolfo Ruiz Cortines, Unidad Médica de Alta Especialidad 189, of the Instituto Mexicano del Seguro Social [High Speciality Medical Unit of the Mexican Institute of Social Welfare], in Veracruz, Mexico. Design: Observational, descriptive, retrospective, cross-sectional study. Statistical analysis: Standard deviation and range, Chi square (χ²) and Mantel-Haenszel test. Linear logistic regression multivariate analysis. Material and methods: A six-year retrospective study of cases and controls reviewing 108 patients undergoing dialysis and subjected to surgery. The group of cases included patients with complications or who died. Assessed risk factors were: age, gender, body mass index, diabetes, type of dialysis, emergency surgery, hemoglobin, urea, creatinine, albumin, and in-hospital stay. Results: The most common surgeries were abdominal wall hernia repair (n = 64), gastrointestinal surgery (n = 18), and laparoscopic cholecystectomy (n = 8). Rates of morbidity and mortality were 25 and 9.3%, respectively. The identified risk factors through the multivariate analysis (p < 0.05) were emergency surgery, low hemoglobin level, low albumin, and in-hospital stay. Multivariate analysis confirmed low albumin and in-hospital stay as risk factors (p < 0.02) for morbidity and mortality. Conclusions: Patients undergoing dialysis have a high rate of complications and mortality after surgery related to factors that yield poor results, which could be corrected to improve the morbidity and mortality rates

Palavras-chave : Morbidity; mortality; risk factors; general surgery; dialysis.