{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:06:55Z","timestamp":1793070415895,"version":"4.5.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007231","name":"Cancer Society in Stockholm","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007231","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Cancer and Allergy Foundation"},{"name":"Regional Agreement on Medical Training and Clinical Research"},{"name":"Region Stockholm"},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Readmission rates following ileostomy formation are high. Dehydration and consecutive renal failure are common causes of readmission, potentially pronounced by drugs affecting the homeostasis. The aim of the study was to assess the risk of dehydration after ileostomy formation in patients treated with angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB) or diuretics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>This nationwide population-based cohort study used data derived from the Colorectal Cancer Data Base of several Swedish healthcare registers. The study included all patients operated on with elective anterior resection and temporary ileostomy for rectal cancer clinically staged I\u2013III in Sweden in 2007\u20132016. Exposure was at least two dispensations of ACEI, ARB or diuretics within 1 year prior to surgery. Outcome was 90-day readmission due to dehydration including acute renal failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 3252 patients were included with 1173 (36.1%) exposed to ACEI, ARB or diuretics. The cumulative incidence for 90-day readmission due to dehydration was 29.0% (151 of 520) for exposed versus 13.8% (98 of 712) for unexposed. The proportion of readmissions due to any reason was 44.3% (520 of 1173) for exposed compared to 34.2% (712 of 2079) for unexposed. The incidence rate ratio for readmission due to dehydration was 2.83 (95% c.i. 2.21 to 3.63, P &amp;lt; 0.001). The hazard rate ratio was 2.45 (95% c.i. 1.83 to 3.27, P &amp;lt; 0.001) after adjusting for age, gender and comorbidity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Medication with ACEI, ARB or diuretics defines a vulnerable patient group with increased risk of readmission due to dehydration after ileostomy formation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrae051","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T20:02:39Z","timestamp":1717185759000},"source":"Crossref","is-referenced-by-count":6,"title":["Preoperative use of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diuretics increases the risk of dehydration after ileostomy formation: population-based cohort study"],"prefix":"10.1093","volume":"8","author":[{"given":"Louise","family":"de la Motte","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"},{"name":"Department of Pelvic Cancer, Colorectal Surgery Unit, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Nordenvall","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"},{"name":"Department of Pelvic Cancer, Colorectal Surgery Unit, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Martling","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"},{"name":"Department of Pelvic Cancer, Colorectal Surgery Unit, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Buchli","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"},{"name":"Department of Pelvic Cancer, Colorectal Surgery Unit, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"2024062805124025300_zrae051-B1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s10151-022-02580-6","article-title":"Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis","volume":"26","author":"Vogel","year":"2022","journal-title":"Tech Coloproctol"},{"key":"2024062805124025300_zrae051-B2","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/codi.14866","article-title":"Renal impairment after ileostomy formation: a frequent event with long-term consequences","volume":"22","author":"Fielding","year":"2020","journal-title":"Colorectal Dis"},{"key":"2024062805124025300_zrae051-B3","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.jss.2016.11.039","article-title":"Ileostomy creation in colorectal cancer surgery: risk of acute kidney injury and chronic kidney disease","volume":"210","author":"Li","year":"2017","journal-title":"J Surg Res"},{"key":"2024062805124025300_zrae051-B4","doi-asserted-by":"crossref","first-page":"zrad010","DOI":"10.1093\/bjsopen\/zrad010","article-title":"Defunctioning loop ileostomy in anterior resection for rectal cancer and subsequent renal failure: nationwide population-based study","volume":"7","author":"Rutegard","year":"2023","journal-title":"BJS Open"},{"key":"2024062805124025300_zrae051-B5","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1111\/codi.15654","article-title":"Risk and consequences of dehydration following colorectal cancer resection with diverting ileostomy. A systematic review and meta-analysis","volume":"23","author":"Borucki","year":"2021","journal-title":"Colorectal Dis"},{"key":"2024062805124025300_zrae051-B6","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s00384-014-1949-0","article-title":"A temporary loop ileostomy affects renal function","volume":"29","author":"Gessler","year":"2014","journal-title":"Int J Colorectal Dis"},{"key":"2024062805124025300_zrae051-B7","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s00595-019-01938-y","article-title":"Early renal dysfunction after temporary ileostomy construction","volume":"50","author":"Yaegashi","year":"2020","journal-title":"Surg Today"},{"key":"2024062805124025300_zrae051-B8","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/s12893-021-01242-y","article-title":"Readmission after rectal resection in the ERAS-era: is a loop ileostomy the Achilles heel?","volume":"21","author":"Van Butsele","year":"2021","journal-title":"BMC Surg"},{"key":"2024062805124025300_zrae051-B9","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1111\/codi.15566","article-title":"Risk factors for readmission with dehydration after ileostomy formation: a systematic review and meta-analysis","volume":"23","author":"Liu","year":"2021","journal-title":"Colorectal Dis"},{"key":"2024062805124025300_zrae051-B10","volume-title":"Statistics and Data. 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