{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:34:18Z","timestamp":1780925658284,"version":"3.54.1"},"reference-count":25,"publisher":"The Korean Society of Critical Care Medicine","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["accjournal.org"],"crossmark-restriction":true},"short-container-title":["ACC"],"published-print":{"date-parts":[[2026,2,28]]},"abstract":"<jats:p>Background: Early postoperative recovery of kidney function is critical in emergency bowel surgery. This study evaluated the prognostic value of preoperative creatinine elevation (PCE) and early creatinine recovery (ECR).Methods: A total of 424 patients underwent emergency surgery for bowel perforation or ischemia from January 2019 to December 2024. Sixteen trauma-related cases (including procedure-related injuries) were excluded, leaving 408 patients for analysis. Of these, 35 patients with end-stage renal disease or chronic kidney disease\u2014either pre-existing or newly diagnosed during hospitalization\u2014were excluded. ECR was defined as a decrease in serum creatinine to &lt;1.3 mg\/dl by postoperative day (POD) 3. PCE was defined as serum creatinine &gt;1.3 mg\/dl. Associations with postoperative complications and 30-day mortality were estimated using multivariable logistic regression and reported as adjusted odds ratios (aORs) with 95% CIs.Results: PCE occurred in 18.5% (69\/373) of the tested patients; among these, 58.0% (40\/69) achieved ECR by POD 3. Failure of ECR was associated with severe complications (93.1% vs. 27.5%, P&lt;0.001) and higher mortality (72.4% vs. 7.5%, P&lt;0.001). In multivariable analysis, ECR failure independently predicted complications (aOR, 28.72; 95% CI, 5.44\u2013151.58) and 30-day mortality (aOR, 32.38; 95% CI, 7.74\u2013135.41; P&lt;0.001 for both).Conclusions: Failure to achieve ECR is independently associated with poor survival after emergency laparotomy for peritonitis. This finding supports the use of a creatinine-based checkpoint to trigger intensified monitoring and targeted rescue interventions.<\/jats:p>","DOI":"10.4266\/acc.003625","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:09:44Z","timestamp":1772176184000},"page":"126-135","update-policy":"https:\/\/doi.org\/10.4266\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Failure of early creatinine recovery predicts poor survival after emergency surgery for bowel perforation or infarction"],"prefix":"10.4266","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2186-5842","authenticated-orcid":true,"given":"Hyun Il","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8054-9308","authenticated-orcid":true,"given":"Min 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guidelines","author":"Park","year":"2024"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1590\/0100-6991e-20222991_en"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.47717\/turkjsurg.2025.6645"}],"container-title":["Acute and Critical 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