Readmission with acute kidney injury following ileostomy: patterns and predictors of a common phenomenon.


Journal

Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285

Informations de publication

Date de publication:
20 Feb 2023
Historique:
received: 13 05 2022
accepted: 13 02 2023
entrez: 22 2 2023
pubmed: 23 2 2023
medline: 25 2 2023
Statut: epublish

Résumé

Ileostomy is associated with various complications, often necessitating rehospitalization. High-output ileostomy is common and may lead to acute kidney injury (AKI). Here we describe the temporal pattern of readmission with AKI following ileostomy formation and identify risk factors. Patients that underwent formation of ileostomy between 2008 and 2021 were included in this study. Readmission with AKI with high output ileostomy was defined as readmission with serum creatinine > 1.5-fold compared to the level at discharge or latest baseline (at least stage-1 AKI according to Kidney Disease: Improving Global Outcome (KDIGO) criteria), accompanied by ileostomy output > 1000 ml in 24 h. Patient characteristics and perioperative course were assessed to identify predictors for readmission with AKI. Of 1191 patients who underwent ileostomy, 198 (16.6%) were readmitted with a high output stoma and AKI. The mean time to readmission with AKI was 98.97 ± 156.36 days. Eighty-six patients (43.4%) had early readmission (within 30 days), and 66 (33%) were readmitted after more than 90 days. Over 90% of patients had more than one readmission, and 110 patients (55%) had 5 or more. Patient-related predictors for readmission with AKI were age > 65, body mass index > 30 kg/m Readmission with AKI following ileostomy formation is a consequential event with distinct risk factors. Acknowledging these risk factors is the foundation for designing interventions aiming to reduce frequency of AKI readmissions in predisposed patient populations.

Identifiants

pubmed: 36805819
doi: 10.1007/s00423-023-02842-3
pii: 10.1007/s00423-023-02842-3
doi:

Substances chimiques

Albumins 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

96

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Niv Pencovich (N)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel. Pencovici.niv@mayo.edu.

Jacob Samuel Silverman (JS)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel.

Nir Horesh (N)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel.

Nadav Nevo (N)

Department of General Surgery, Faculty of Health Sciences, Assuta Medical Center, Ashdod, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Rony Eshkenazy (R)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel.

Ilan Kent (I)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel.

Edward Ram (E)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel.

Ido Nachmany (I)

Department of General Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Tel-Aviv, Israel.

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