Perioperative fluid administration and complications in emergency gastrointestinal surgery-an observational study
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Perioperative fluid administration and complications in emergency gastrointestinal surgery-an observational study. / Voldby, Anders W; Aaen, Anne A; Loprete, Roberto; Eskandarani, Hassan A; Boolsen, Anders W; Jønck, Simon; Ekeloef, Sarah; Burcharth, Jakob; Thygesen, Lau C; Møller, Ann M; Brandstrup, Birgitte.
In: Perioperative Medicine, Vol. 11, 9, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Perioperative fluid administration and complications in emergency gastrointestinal surgery-an observational study
AU - Voldby, Anders W
AU - Aaen, Anne A
AU - Loprete, Roberto
AU - Eskandarani, Hassan A
AU - Boolsen, Anders W
AU - Jønck, Simon
AU - Ekeloef, Sarah
AU - Burcharth, Jakob
AU - Thygesen, Lau C
AU - Møller, Ann M
AU - Brandstrup, Birgitte
N1 - © 2021. The Author(s).
PY - 2022
Y1 - 2022
N2 - BACKGROUND: The fluid balance associated with a better outcome following emergency surgery is unknown. The aim of this study was to explore the association of the perioperative fluid balance and postoperative complications during emergency gastrointestinal surgery.METHODS: We retrospectively included patients undergoing emergency surgery for gastrointestinal obstruction or perforation. A perioperative fluid balance of 2.5 L divided the cohort in a conservative and liberal group. Outcome was Clavien-Dindo graded complications registered 90 days postoperatively. We used logistic regression adjusted for age, sex, American Society of Anesthesiologists' classification, use of epidural analgesia, use of vasopressor, type of surgery, intraabdominal pathology, and hospital. Predicted risk of complications was demonstrated on a continuous scale of the fluid balance.RESULTS: We included 342 patients operated between July 2014 and July 2015 from three centers. The perioperative fluid balance was 1.6 L IQR [1.0 to 2.0] in the conservative vs. 3.6 L IQR [3.0 to 5.3] in the liberal group. Odds ratio of overall 2.6 (95% CI 1.5 to 4.4), p < 0.001, and cardiopulmonary complications 3.2 (95% CI 1.9 to 5.7), p < 0.001, were increased in the liberal group. A perioperative fluid balance of 0-2 L was associated with minimal risk of cardiopulmonary complications compared to 1.5-3.5 L for renal complications.CONCLUSION: We found a perioperative fluid balance above 2.5 L to be associated with an increased risk of overall and cardiopulmonary complications following emergency surgery for gastrointestinal obstruction or perforation. A perioperative fluid balance of 0-2 L was associated with the lowest risk of cardiopulmonary complications and 1.5-3.5 L for renal complications.
AB - BACKGROUND: The fluid balance associated with a better outcome following emergency surgery is unknown. The aim of this study was to explore the association of the perioperative fluid balance and postoperative complications during emergency gastrointestinal surgery.METHODS: We retrospectively included patients undergoing emergency surgery for gastrointestinal obstruction or perforation. A perioperative fluid balance of 2.5 L divided the cohort in a conservative and liberal group. Outcome was Clavien-Dindo graded complications registered 90 days postoperatively. We used logistic regression adjusted for age, sex, American Society of Anesthesiologists' classification, use of epidural analgesia, use of vasopressor, type of surgery, intraabdominal pathology, and hospital. Predicted risk of complications was demonstrated on a continuous scale of the fluid balance.RESULTS: We included 342 patients operated between July 2014 and July 2015 from three centers. The perioperative fluid balance was 1.6 L IQR [1.0 to 2.0] in the conservative vs. 3.6 L IQR [3.0 to 5.3] in the liberal group. Odds ratio of overall 2.6 (95% CI 1.5 to 4.4), p < 0.001, and cardiopulmonary complications 3.2 (95% CI 1.9 to 5.7), p < 0.001, were increased in the liberal group. A perioperative fluid balance of 0-2 L was associated with minimal risk of cardiopulmonary complications compared to 1.5-3.5 L for renal complications.CONCLUSION: We found a perioperative fluid balance above 2.5 L to be associated with an increased risk of overall and cardiopulmonary complications following emergency surgery for gastrointestinal obstruction or perforation. A perioperative fluid balance of 0-2 L was associated with the lowest risk of cardiopulmonary complications and 1.5-3.5 L for renal complications.
U2 - 10.1186/s13741-021-00235-y
DO - 10.1186/s13741-021-00235-y
M3 - Journal article
C2 - 35189974
VL - 11
JO - Perioperative Medicine
JF - Perioperative Medicine
SN - 2047-0525
M1 - 9
ER -
ID: 298129571