Gender as a risk factor for adverse intraoperative and postoperative outcomes of elective pancreatectomy

Mazmudar, Aditya; Vitello, Dominic; Chapman, Mackenzie E.; Tomlinson, James S.; Bentrem, David J.

doi:10.1002/jso.24488

Cited by 21 publications

(36 citation statements)

References 20 publications

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“…Men have more intra-abdominal visceral adipose tissue than women [39]. Similar to our study, a past investigation found that male sex was a significant predictor of increased operative time, length of stay, transfusions, blood loss, and postoperative surgical-site infections [9]. Male sex is a risk factor for morbidity after LDP owing to the increased likelihood of visceral obesity and the technical difficulty associated with operating on patients with visceral obesity.…”

Section: Discussionsupporting

confidence: 86%

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Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Song

Hong

Kim

et al. 2020

JCM

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Although laparoscopic distal pancreatectomy (LDP) has become more popular, the postoperative complication rate remains high. We sought to identify the risk factors for post-LDP complications. We examined 1227 patients who underwent LDP between March 2005 and December 2015 at a single large-volume center. We used logistic regression for the analysis. The overall (13.2%) and major (3.3%) complication rates were determined. Postoperative pancreatic fistula was the most frequent complication, and 58 patients (4.7%) had clinically significant (grade B) pancreatic fistulas. No 90-day mortality was recorded. Long operative time (≥200 min), large estimated blood loss (≥320 mL), LDP performed by an inexperienced surgeon (<50 cases), and concomitant splenectomy were identified as risk factors for overall complications using a logistic regression model. For major complications, male sex (p = 0.020), long operative time (p = 0.005), and LDP performed by an inexperienced surgeon (p = 0.026) were significant predictive factors. Using logistic regression analysis, surgery-related factors, including long operative time and LDP performed by an inexperienced surgeon, were correlated with overall and major complications of LDP. As LDP is a technically challenging procedure, surgery-related variables emerged as the main risk factors for postoperative complications. Appropriate patient selection and sufficient surgeon experience may be essential to reduce the complications of LDP.

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Section: Discussionsupporting

confidence: 86%

“…We performed multivariate analyses using the candidate variables that were introduced as risk factors for complications after distal pancreatectomy in previous studies, as discussed below [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Song

Hong

Kim

et al. 2020

JCM

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“…Moreover, our previous studies and along with others have supported that overweight body status (body mass index greater than or equal to 25 kg/m 2 ) contributes to adverse perioperative outcomes for pancreatectomies . Overweight body status is associated with increased operation duration, blood loss, and superficial SSI . Our report emphasizes the increasing risk for readmission with overweight individuals.…”

Section: Discussionsupporting

confidence: 73%

“…24,;25 Overweight body status is associated with increased operation duration, blood loss, and superficial SSI. [24][25][26] Our report emphasizes the increasing risk for readmission with overweight individuals. Although ERAS pathways have been shown to decrease length of stay without compromising outcomes, BMI may be an important variable in risk stratification for choosing patients to participate in ERAS pathways.…”

Section: Discussionmentioning

confidence: 63%

The association of length of hospital stay with readmission after elective pancreatic resection

Mazmudar¹,

Castle²,

Yang³

et al. 2018

Journal of Surgical Oncology

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“…Sex is a factor, which plays an important role when estimating the probability of disease and complication across all fields of medicine. With regard to SSI, previous studies have demonstrated that generally, SSI occur more frequently in men than in women [3–5]. However, when looking at specific procedure types, this statement is not always accurate.…”

Section: Introductionmentioning

confidence: 99%

Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany

Aghdassi

Schröder

Gastmeier

2019

Antimicrob Resist Infect Control

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Background Surgical site infections (SSI) are among the most frequently occurring healthcare-associated infections worldwide. Various analyses to determine risk factors have been conducted in the past, generally attributing a higher SSI-risk to male patients. However, when focusing on specific procedures, this is not always true. Our objective was to identify for which procedures male or female sex represents an independent risk factor for SSI and which parameters may explain these differences. Methods We used the database of surgical procedures from the German national nosocomial infection surveillance system. We included procedures conducted between 2008 and 2017. We excluded procedures solely executed for one sex (e.g. mastectomy) and procedures with 20,000 or fewer operations. The observed outcome was the occurrence of SSI. All models were adjusted for confounders, which were eliminated with backward selection. The following factors were included in the analysis: age, ASA score, wound contamination class, duration of surgery, and season. All models contained the investigated factor sex. Results Sixteen procedure types with 1,266,782 individual procedures and 18,824 SSI were included. Overall, the incidence rate ratio and the adjusted odds ratio for SSI were significantly higher for male patients. The included individual procedures were grouped into five surgical categories. For orthopedics and traumatology as well as abdominal surgery, SSI-rates were significantly higher for male patients. For heart and vascular surgery, SSI-rates were significantly higher for female patients. Other included surgical categories and individual procedures yielded diverse results. Similar results were found when solely analyzing deep and organ-space SSI. Multivariable analysis for attributable gender-related risk factors revealed differences with regard to underlying risk factors. Conclusions SSI-rates differ by sex for certain procedures. When examining underlying risk factors, differences between male and female patients can be demonstrated. Our analysis considered a limited number of parameters, which were not sufficient to fully explain the observed differences. Further studies are required to obtain a more comprehensive understanding of the topic and to include gender-specific aspects into future SSI-prevention strategies. Electronic supplementary material The online version of this article (10.1186/s13756-019-0547-x) contains supplementary material, which is available to authorized users.

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Gender as a risk factor for adverse intraoperative and postoperative outcomes of elective pancreatectomy

Abstract: Male gender is a significant predictor of increased operative time, length of stay, transfusions, EBL > 1L, as well as postoperative organ space surgical site infections in these patients. J. Surg. Oncol. 2017;115:131-136. © 2016 Wiley Periodicals, Inc.

Cited by 21 publications

References 20 publications

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

The association of length of hospital stay with readmission after elective pancreatic resection

Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany

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