title: Mortality in patients with end-stage renal disease and the risk of returning to the operating room after common General Surgery procedures.
abstract: BACKGROUND
  The prevalence of end-stage renal disease (ESRD) has increased, and there is limited data on the risks faced by this patient population undergoing surgery.
  
  
  METHODS
  Using American College of Surgeons National Surgical Quality Improvement Program, we identified common surgical procedures undergone by patients with ESRD. These patients were compared with a matched-control group. A subanalysis was performed to determine the risk factors for returning to the operating room in patients with ESRD.
  
  
  RESULTS
  Of the 195,585 patients identified, 1,163 had ESRD. ESRD was associated with increased mortality (odds ratio [OR] 9.05, confidence interval [CI] 4.09 to 20.00) and rates of return to the operating room (OR 2.97, CI 1.99 to 4.46). Returning to the OR was associated with increased operation times (98.9 vs 130.2 minutes, P < .05), mortality (OR 4.35, CI 2.11 to 8.99), and morbidity (OR 7.6, CI 4.68 to 12.41).
  
  
  CONCLUSIONS
  Patients with ESRD face greater risks when entering the operating room, and further study is needed to elucidate preventable risk factors.
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA. Electronic address: katrina.brakoniecki@downstate.edu.
authors.forename: Katrina
authors.initials: K
authors.lastname: Brakoniecki
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA; Department of Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: Sophia
authors.initials: S
authors.lastname: Tam
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Chung
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Alfonso
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
authors.forename: Gainosuke
authors.initials: G
authors.lastname: Sugiyama
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000401:mortality; D006435:Renal Dialysis / Q000009:adverse effects; D012086:Reoperation / Q000401:mortality*; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000401:mortality*; D014481:United States / Q000453:epidemiology
keywords: Appendectomy; Cholecystectomy; Colectomy; Dialysis; ESRD; Ventral hernia repair