Preoperative renal dysfunction and mortality after non‐cardiac surgery. BJS 2016; 103: 1316-1325.

Results

In
EuSOS, 1580 (4·3 per cent) of 36 779 patients died in hospital; in NCEPOD, 298 (2·8 per cent) of 10 466 patients had died by 60 days after surgery. Chronic kidney disease (eGFR below 60·0 ml per min per 1·73 m²) was present in 6415 patients (17·4 per cent) in EuSOS and 2262 (21·6 per cent) in NCEPOD. Preoperative chronic kidney disease was associated with older age, men, diagnosis of diabetes, cardiovascular or respiratory disease, and non‐elective surgery. Preoperative eGFR categories below 60·0 ml per min per 1·73 m² were associated with increasing adjusted hazard ratios (HRs) for death compared with a value of 90·0 ml per min per 1·73 m² and above. In EuSOS, the risk of death increased with lower eGFR category, to a maximum with eGFR 15·0–29·9 ml per min per 1·73 m² (HR 3·37, 95 per cent c.i. 2·70 to 4·22). In NCEPOD, the risk of death also increased with declining eGFR and was maximal for eGFR below 15·0 ml per min per 1·73 m² (HR 3·40, 1·78 to 6·50).