Postoperative serum urea is associated with 30-day mortality in patients undergoing emergency abdominal surgery

Harten, J., Hay, A., McMillan, D.C., McArdle, C.S., O'Reilly, D. and Kinsella, J. (2006) Postoperative serum urea is associated with 30-day mortality in patients undergoing emergency abdominal surgery. Annals of Clinical Biochemistry, 43(4), pp. 295-299.

Abstract

<p><b>BACKGROUND:</b> Emergency abdominal surgery carries considerable postoperative morbidity and mortality. Hypovolaemia is considered to be a cause of renal hypoperfusion, which is associated with a decreased clearance of serum urea and creatinine. This study examines whether the perioperative serum urea and creatinine concentrations are predictors of mortality in patients undergoing emergency abdominal surgery.</p> <p><b>METHODS:</b> Consecutive patients (n=300) who underwent emergency abdominal surgery were studied. Age- and sex-specific reference intervals were used for the data analysis. Patients with incomplete biochemical (n=51) or mortality data (n=31) or with pre-existing renal failure (n=9) were excluded from the analysis.</p> <p><b>RESULTS:</b> 209 patients were analysed, of whom 162 (78%) remained alive and 47 (22%) died following surgery. The non-survivors were older (P<0.05), had undergone more extensive surgery (P<0.001) and were more likely to have been admitted to the intensive care unit (P<0.001). The serum urea concentration was higher preoperatively (P<0.05) and on day one postoperatively (P<0.001) in the non-survivors. On multivariate logistic regression analysis, age (odds ratio [OR] 3.27, 95% confidence interval [CI] 1.43-7.47, P<0.005), severity of surgery (OR 2.21, 95% CI 1.14-4.29, P<0.019), admission to intensive care (OR 0.54, 95% CI 0.11-0.54, P<0.001), seniority of anaesthetist (OR 0.50, 95% CI 0.27-0.90, P<0.022) and day one urea (OR 3.33, 95% CI 1.39-7.99, P<0.007) were independently associated with 30-day mortality.</p> <p><b>CONCLUSIONS:</b> These results indicate that an increased serum urea concentration, but not serum creatinine concentration, in the postoperative period is associated with an increase in 30-day mortality in patients undergoing emergency abdominal surgery.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Harten, Dr Johann and O'Reilly, Dr Denis and Kinsella, Professor John and McMillan, Professor Donald
• Authors: Harten, J., Hay, A., McMillan, D.C., McArdle, C.S., O'Reilly, D., and Kinsella, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: Annals of Clinical Biochemistry
• ISSN: 0004-5632

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