Risk Factors for Overall Complications and Remote Infection After Gastrectomy in Elderly Gastric Cancer Patients

Abstract

Background/Aim: A significant predictive factor for the occurrence of complications after gastrectomy in elderly gastric cancer patients is yet to be determined. We aimed to evaluate the clinical factors associated with overall complications including remote infection after gastrectomy in elderly gastric cancer patients. Patients and Methods: We retrospectively analyzed data of 101 patients aged over 80 years, who underwent curative gastrectomy. We analyzed the clinicopathological factors that were independently associated with the occurrence of overall complications or remote infection by a logistic regression model. Results: The overall complication rate was 24.8%. We identified pneumonia as a remote infection, and the occurrence rate of remote infections was 5.9%. On multivariate analysis, hemoglobin (<11 g/dl) and operation time (>240 min) were significantly correlated with the occurrence of overall complications. Regarding the occurrence of remote infection, performing total gastrectomy and a hemoglobin level <11 g/dl were identified as significant risk factors. Conclusion: Preoperative anemia and intraoperative factors, including the surgical procedure, could affect the occurrence of postoperative complications in elderly patients.

A web‐based calculator combining Geriatric Nutritional Risk Index (GNRI) and Tilburg Frailty Indicator (TFI) predicts postoperative complications among young elderly patients with gastric cancer

“…However, the study by Nakamura et al . showed that the total complication rate among elderly patients with gastric cancer was 24.8% 23 . Similar results were also found in Yang et al .…”

“…However, the study by Nakamura et al showed that the total complication rate among elderly patients with gastric cancer was 24.8%. 23 Similar results were also found in Yang et al that the rate of the total complications was 13.6%-25%. 24 This can be explained by the fact Hence, our participants had a higher rate of postoperative complications than that previously reported.…”

Risk factors associating with delayed gastric emptying after laparoscopic distal gastrectomy

“…1 Recently, with the greater population of elderly people in Japan, the rate of laparoscopic gastrectomy has been rapidly increasing among elderly patients with GC. 3 By contrast, the prevalence rate of postoperative DGE ranges from 5% to 10% based on clinical symptoms. 4,5 Clinically diagnosed DGE is generally a mild condition.…”

“…In JCOG 0912, the overall incidence rate of in‐hospital grade 3–4 surgical complications (Clavien–Dindo Classification) was only 3.3% among the patients who underwent LDG 1 . Recently, with the greater population of elderly people in Japan, the rate of laparoscopic gastrectomy has been rapidly increasing among elderly patients with GC 3 …”

Surgical prehabilitation in older and frail individuals: a scoping review

“…For instance, a recent study from the Netherlands5 examined outcomes in octogenarians following major surgical procedures and found that, depending on the diagnosis, they had increased median length of stay, 30-day major morbidity, and 30-day mortality. Additional risk factors for overall complications in elderly patients scheduled for surgery include smoking and alcohol consumption,6 malnutrition,6 excessive polypharmacy,7 mental health disorders (eg, preoperative depression or anxiety),8,9 hemoglobin < 11 g/dl,6,10 diabetes and glycemic control (eg, increased HBA1c) 6. These studies and many others highlight the significant risks associated with surgical and other interventions performed on older and frail individuals, and it has been suggested that prehabilitation may be an important antidote that supports improved outcomes 11…”