title: Risk factors for postoperative complications in patients on maintenance hemodialysis who undergo abdominal surgery.
abstract: OBJECTIVE
  Patients on hemodialysis (HD) who undergo abdominal surgery for gastrointestinal disease are at increased risk of postoperative complications. In this study, we retrospectively investigated the predictors of postoperative complications among such patients.
  
  
  METHODS
  The study group comprised 36 HD patients who underwent abdominal surgery for gastrointestinal disease between 2003 and 2012. The clinicopathological factors of the patients who did and did not suffer postoperative complications were compared.
  
  
  RESULTS
  The overall morbidity and mortality rates were 39% (14/36) and 14% (5/36), respectively. Physical status according to the American Society of Anesthesiologists (ASA) classification (p = 0.0203) and intraoperative blood loss (p = 0.0013) were found to differ significantly between the groups.
  
  
  CONCLUSIONS
  The morbidity and mortality rates of HD patients who underwent abdominal surgery for gastrointestinal disease were high. Physical status according to the ASA classification and intraoperative blood loss were found to be associated with postoperative complications. Therefore, patients with comorbidities, such as heart disease and diabetes mellitus, have to be treated appropriately before surgery. In addition, it is important that surgeons perform operations carefully and avoid excessive blood loss.
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan. Electronic address: tomo-ito@juntendo.ac.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maekawa
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Sakurada
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Orita
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kushida
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Senuma
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: abdominal surgery; complication; gastrointestinal disease; hemodialysis; maintenance hemodialysis