Association Between Perioperative Diuretic Use and Postoperative Outcomes Following Dermatologic Surgery: A TriNetX Based Cohort Study

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.