Risk factors of the postoperative 30-day readmission of gastric cancer surgery after discharge

Wu, Weiwei; Zhang, Weihan; Zhang, Weiyi; Yang, Lei; Deng, Xiaoqian; Zhu, Tao

doi:10.1097/md.0000000000014639

Cited by 8 publications

(5 citation statements)

References 36 publications

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“…In this study, high BMI, DM, and long operation time were detected as risk predictor for PCs in patients treated with NAC. These factors are well known predictors of complications in primary surgery (21)(22)(23)(24). High BMI is closely related to excessive visceral fat which may cause extend the operation time and impair lymph node dissection (25,26), increasing the difficulty of the whole operation.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single Center Retrospective Study

Hayashi

Yoshikawa²,

Yura

et al. 2020

Preprint

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KEYWORDS 2 gastrectomy, neoadjuvant chemotherapy, surgical Apgar score 3 Abstract Background: The surgical Apgar score (SAS) or modified SAS (mSAS) has been reported as a simple and easy risk assessment system to predict postoperative complications (PCs) in primary surgery for gastric cancer (GC). However, there are still few studies which revealed the SAS's utility in gastric surgery after neoadjuvant chemotherapy (NAC). Methods: One hundred and fifteen patients who received NAC and R0 gastrectomy from 2008 and 2015 were included in this study. The SAS was determined by estimated blood loss (EBL), lowest intraoperative mean arterial pressure (LMAP), and lowest heat rate (LHR). The mSAS was determined by the EBL reassessed using the interquartile values. The predictive values of the SAS/mSAS for PCs were assessed with uni and multivariate analyses. Results: Among 115 patients, 41 (35.7%) developed PCs. According to analyses with receiver operating characteristic (ROC) curve of the SAS and mSAS for predicting PCs, the cutoff value of the mSAS was set at 8. The rates of anastomotic leakage, pancreatic fistula, and arrhythmia in patients with high mSAS (>8) values were higher, compared to those with low (0-3) and moderate (4-7) mSAS values. A multiple logistic regression analysis detected operation time, Body Mass Index (BMI), and Diabetes Mellitus (DM) were independent risk factors for PCs. The mSAS was not a significant predictor.Conclusions: Neither the SAS nor mSAS was a useful predictor of PCs in patients treated with NAC followed by radical gastrectomy. The predictive value of SAS/mSAS is limited in patients undergoing surgery after NAC.

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Section: Discussionmentioning

confidence: 99%

Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single Center Retrospective Study

Hayashi

Yoshikawa²,

Yura

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In this study, a high BMI, the presence of DM, and a long operation time were detected as risk predictors for postoperative complications in patients treated with NAC. These factors are well known predictors of complications in primary surgery [ 20 – 23 ]. A high BMI is closely related to excessive visceral fat, which may extend the operation time and impair lymph node dissection [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of the surgical Apgar score on postoperative complications in advanced gastric cancer patients treated with neoadjuvant chemotherapy followed by radical gastrectomy: a single-center retrospective study

et al. 2020

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Background: The surgical Apgar score (SAS) or modified SAS (mSAS) has been reported as a simple and easy risk assessment system for predicting postoperative complications in primary surgery for gastric cancer. However, few studies have described the SAS's utility in gastric surgery after neoadjuvant chemotherapy (NAC). Methods: One hundred and fifteen patients who received NAC and radical gastrectomy from 2008 and 2015 were included in this study. The SAS was determined by the estimated blood loss (EBL), lowest intraoperative mean arterial pressure, and lowest heart rate. The mSAS was determined by the EBL reassessed using the interquartile values. The predictive values of the SAS/mSAS for postoperative complications were assessed with univariate and multiple logistic regression analyses. Results: Among the 115 patients, 41 (35.7%) developed postoperative complications. According to analyses with receiver operating characteristic curves of the SAS and mSAS for predicting postoperative complications, the cutoff value of the mSAS was set at 8. The rates of anastomotic leakage, pancreatic fistula, and arrhythmia in patients with high mSAS (> 8) values were higher than in those with low (0-3) and moderate [1-4] mSAS values. A multiple logistic regression analysis showed that the operation time, body mass index, and diabetes mellitus were independent risk factors for postoperative complications. The mSAS was not a significant predictor. Conclusion: The predictive value of SAS or mSAS for morbidity may be limited in patients who undergo gastric cancer surgery after NAC. Future prospective studies with a large sample size will be needed to confirm the present results.

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“…The primary outcome of interest was admission to the ICU within 30 days after surgery. This length of time has been used in various studies across cancer and non-cancer surgical fields to assess for postoperative complications (Fisher et al 2017, Goel et al 2019, Quero-Valenzuela et al 2018, Wu et al 2019). This was retrieved from electronic medical records.…”

Section: Methodsmentioning

confidence: 99%

Intraoperative haemodynamics and postoperative intensive care unit admission in older patients with cancer

Afonso

Sastow

Cadwell

et al. 2021

Journal of Perioperative Practice

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Purpose Research on the impact of various intraoperative haemodynamic variables on the incidence of postoperative ICU admission among older patients with cancer is limited. In this study, the relationship between intraoperative haemodynamic status and postoperative intensive care unit admission among older patients with cancer is explored. Methods Patients aged ≥75 who underwent elective oncologic surgery lasting ≥120min were analysed. Chi-squared and t-tests were used to assess the associations between intraoperative variables with postoperative intensive care unit admission. Multivariable regressions were used to analyse potential predict risk factors for postoperative intensive care unit admission. Results Out of 994 patients, 48 (4.8%) were admitted to the intensive care unit within 30 days following surgery. Intensive care unit admission was associated with the presence of ≥4 comorbid conditions, intraoperative blood loss ≥100mL, and intraoperative tachycardia and hypertensive urgency. On multivariable analysis, operation time ≥240min (Odds Ratio [OR] = 2.29, p = 0.01), and each minute spent with intraoperative hypertensive urgency (OR = 1.06, p = 0.01) or tachycardia (OR = 1.01, p = 0.002) were associated with postoperative intensive care unit admission. Conclusion Intraoperative hypertensive urgency and tachycardia were associated with postoperative intensive care unit admission in older patients undergoing cancer surgery.

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Risk factors of the postoperative 30-day readmission of gastric cancer surgery after discharge

Cited by 8 publications

References 36 publications

Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single Center Retrospective Study

Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single Center Retrospective Study

Predictive value of the surgical Apgar score on postoperative complications in advanced gastric cancer patients treated with neoadjuvant chemotherapy followed by radical gastrectomy: a single-center retrospective study

Intraoperative haemodynamics and postoperative intensive care unit admission in older patients with cancer

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