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Related Experiment Videos

Modest serum creatinine elevation affects adverse outcome after general surgery.

Maureen M O'Brien1, Ralph Gonzales, A Laurie Shroyer

  • 1Division of Cardiac Research, Denver Veterans Affairs Medical Center, Colorado, USA.

Kidney International
|July 12, 2002
PubMed
Summary

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Elevated preoperative serum creatinine levels (over 1.5 mg/dL) significantly predict increased morbidity and mortality risk in general surgery patients. This readily available marker helps identify individuals at higher risk for adverse outcomes.

Area of Science:

  • Nephrology
  • Surgical Outcomes Research
  • Public Health

Background:

  • Previous studies linked modest preoperative serum creatinine elevation (1.5-3.0 mg/dL) to adverse outcomes in cardiac surgery.
  • The applicability of this finding to general surgery populations remained unclear.

Purpose of the Study:

  • To investigate the association between preoperative serum creatinine levels and postoperative morbidity and mortality in patients undergoing general surgery.
  • To determine if a serum creatinine threshold of 1.5 mg/dL is predictive of adverse outcomes in this population.

Main Methods:

  • Analysis of 49,081 major general surgery cases from the Veterans Affairs National Surgical Quality Improvement Program (1996-1998).
  • Multivariable logistic regression models were used to assess the impact of 46 risk variables, including serum creatinine.

Related Experiment Videos

  • Patients were stratified based on preoperative serum creatinine levels: 1.5-3.0 mg/dL and >3.0 mg/dL.

    • Main Results:

    • Serum creatinine >1.5 mg/dL was significantly associated with higher 30-day mortality (adjusted OR 1.44 for 1.5-3.0 mg/dL, 1.93 for >3.0 mg/dL).
    • Increased morbidity (one or more complications) was also observed with elevated creatinine (adjusted OR 1.18 for 1.5-3.0 mg/dL).
    • A preoperative serum creatinine level exceeding 1.5 mg/dL emerged as a critical threshold for increased risk.

    Conclusions:

    • Modest preoperative serum creatinine elevation (>1.5 mg/dL) is a significant, independent predictor of risk-adjusted morbidity and mortality following general surgery.
    • Preoperative serum creatinine serves as a practical and accessible biomarker for identifying patients at elevated risk of adverse surgical outcomes.