Related Experiment Videos
Association between perioperative diuretic use and postoperative outcomes following Mohs micrographic surgery
Abstract:
Patients undergoing Mohs micrographic surgery (MMS) on perioperative diuretics represent a medically complex population, yet the impact of diuretic use on postoperative outcomes remains underexplored. Despite use in patients with cardiometabolic comorbidities, limited research has evaluated how perioperative diuretic exposure influences postoperative outcomes following MMS. This study investigates the association between perioperative diuretic use and postoperative outcomes following MMS. Utilizing the TriNetX database, MMS patients were matched on a 1 : 1 basis according to perioperative diuretic use. Outcome variables were evaluated over a 30- and 90-day follow-up period. Among 37,781 matched patients, diuretic use was associated with higher odds of surgical site infection at both 30 days (OR 1.29, 95% CI 1.03 - 1.62, p = 0.03) and 90 days (OR 1.36, 95% CI 1.12 - 1.65, p < 0.001), as well as substantially increased odds of rash or cellulitis at 30 days (OR 1.95, 95% CI 1.68 - 2.26, p < 0.001) and 90 days (OR 1.92, 95% CI 1.74 - 2.13, p < 0.001). Perioperative diuretic use was linked to increased odds of infection, rash or cellulitis, postoperative pain, opioid use, emergency department visits, sepsis, and short-term mortality, with time-to-event analysis identifying loop and osmotic diuretics as the primary drivers of risk.
Insights
Diuretic use in patients undergoing Mohs surgery increases risks for infection, rash, and other complications. Loop and osmotic diuretics were identified as key risk factors for adverse postoperative outcomes.
Area of Science:
- Dermatology
- Pharmacology
- Public Health
Background:
- Patients undergoing Mohs micrographic surgery (MMS) often have cardiometabolic conditions requiring diuretic use.
- The impact of perioperative diuretic exposure on MMS outcomes is not well understood.
Purpose of the Study:
- To investigate the association between perioperative diuretic use and postoperative outcomes in patients undergoing MMS.
- To identify specific diuretic classes contributing to adverse events.
Main Methods:
- Retrospective cohort study using the TriNetX database.
- 1:1 matched analysis of patients based on perioperative diuretic use.
- Evaluation of outcomes at 30 and 90 days post-surgery.
Main Results:
- Diuretic use was associated with significantly higher odds of surgical site infection (30-day OR 1.29, 95% CI 1.03-1.62; 90-day OR 1.36, 95% CI 1.12-1.65).
- Increased odds of rash or cellulitis were observed (30-day OR 1.95, 95% CI 1.68-2.26; 90-day OR 1.92, 95% CI 1.74-2.13).
- Diuretic use correlated with higher risks of pain, opioid use, ED visits, sepsis, and short-term mortality; loop and osmotic diuretics were primary drivers.
Conclusions:
- Perioperative diuretic use is linked to a higher incidence of postoperative complications following Mohs surgery.
- Clinicians should consider diuretic status when assessing surgical risk and managing patients undergoing MMS.
- Further research into optimizing perioperative management for diuretic users is warranted.
