High preoperative ratio of blood urea nitrogen to creatinine increased mortality in gastrointestinal cancer patients who developed postoperative enteric fistulas.
Development of an enteric fistula after surgery is a major therapeutic complication. In this study, we retrospectively examined the potential relationship between preoperative laboratory data and patient mortality by collecting patient data from a tertiary medical center. We included patients who developed enteric fistulas after surgery for gastrointestinal (GI) cancer between January 2005 and December 2010. Patient demographics and data on preoperative and pre-parenteral nutritional statuses were compared between surviving and deceased patients. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to determine the predictors and cut-off values, respectively. Patients with incomplete data and preoperative heart, lung, kidney, and liver diseases were excluded from the study; thus, out of 65 patients, 43 were enrolled. Logistic regression analysis showed that blood urea nitrogen-to-creatinine (BUN/Cr) ratio [p = 0.007; OR = 0.443, 95% confidence interval (CI), 0.245-0.802] was an independent predictor of mortality in patients who developed enteric fistulas after surgery for GI cancer. In conclusion, the results of our study showed that a high preoperative BUN/Cr ratio increases the risk of mortality in patients who develop enteric fistulas after surgery for GI cancer.
Division of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hsing-Lin
HL
Lin
Chao-Wen
CW
Chen
Chien-Yu
CY
Lu
Li-Chu
LC
Sun
Ying-Ling
YL
Shih
Jui-Fen
JF
Chuang
Yu-Ho
YH
Huang
Maw-Chang
MC
Sheen
Jaw-Yuan
JY
Wang
D000368:Aged; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood*; D016154:Digestive System Fistula / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D057234:Preoperative Period; D012307:Risk Factors
D003404:Creatinine