Background. Preoperative risk stratification and optimising care of patients undergoing elective surgery are important to reduce\nthe risk of postoperative outcomes. Renal dysfunction is becoming increasingly prevalent, but its impact on patients undergoing\nelective gastrointestinal surgery is unknown although much evidence is available for cardiac surgery. This study aimed to investigate\nthe impact of preoperative estimated glomerular filtration rate (eGFR) and postoperative outcomes in patients undergoing\nelective gastrointestinal surgeries. Methods. This prospective study included consecutive adult patients undergoing\nelective gastrointestinal surgeries attending preassessment screening (PAS) clinics at the Queen Elizabeth Hospital Birmingham\n(QEHB) between July and August 2016. Primary outcome measure was 30-day overall complication rates and secondary outcomes\nwere grade of complications, 30-day readmission rates, and postoperative care setting. Results. This study included 370 patients, of\nwhich 11% (41/370) had eGFR of <60 ml/min/1.73m2. Patients with eGFR < 60 ml/min/1.73m2 were more likely to have ASA\ngrade 3/4 (p < 0.001) and >2 comorbidities (p < 0.001). Overall complication rates were 15% (54/370), with no significant\ndifference in overall (p 0.644) and major complication rates (p 0.831) between both groups. In adjusted models, only surgery\ngrade was predictive of overall complications. Preoperative eGFR did not impact on overall complications (HR: 0.89, 95% CI:\n0.45ââ?¬â??1.54 p 0.2). Conclusions. Preoperative eGFR does not appear to impact on postoperative complications in patients\nundergoing elective gastrointestinal surgeries, even when stratified by surgery grade. These findings will help preassessment clinics\nin risk stratification and optimisation of perioperative care of patients.
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