NECK SURGERIES IN PATIENTS WITH CHRONIC KIDNEY DISEASE zorbasko@gmail.com

396-02

NECK SURGERIES IN PATIENTS WITH CHRONIC KIDNEY DISEASE

5

 

 

 

 

United States

Oral or Poster

End-stage renal disease (ESRD) impairs platelet function, placing affected patients at an increased risk of intraoperative and postoperative bleeding. In addition, ESRD is frequently accompanied by other comorbidities, such as arterial calcifications, which further elevate surgical risk. Consequently, patients with ESRD who undergo any type of operation are theoretically more susceptible to complications. This study aimed to utilize a large, multi-institutional database to investigate the impact of chronic kidney disease and ESRD on outcomes in patients undergoing neck surgeries.

The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent either thyroidectomy or parathyroidectomy or lymph node resection of the neck from 2022 to 2023 by using the CPT codes. They were stratified by preoperative estimated glomerular filtration rates (eGFR) and grouped into five cohorts.The primary outcome was 30-day mortality and secondary outcomes included perioperative bleeding, reoperation and prolonged hospital stay. Univariate logistic regression was used to calculate the odds of having postoperative mortality and complications.

The final population consists of 39248 patients. Patients with GFR<30 and eGFR 15-29 had higher risk of 30 days mortality, perioperative bleeding, reoperation and prolonged hospital stay. Patients with eGFR 60-89 had higher risk for perioperative bleeding and reoperation.

Patients candidates for neck surgeries, low eGFR is an important risk factor to consider, as those with eGFR<30 and eGFR appear to be at significantly higher risk of mortality, perioperative bleeding, need for reoperation and prolonged hospital stay.