CANCER PATIENTS AND MAJOR COMPLICATIONS PREDICTORS AFTER ELECTIVE ABDOMINAL SURGERY

被引:0
作者
Fatima, Shahar Bano [1 ]
Islam, Izzah [2 ]
Ch, Maryam Asim [3 ]
机构
[1] Univ Lahore, Univ Coll Med, Lahore, Pakistan
[2] Yusra Med & Dent Coll, Islamabad, Pakistan
[3] Rawalpindi Med Coll, Rawalpindi, Pakistan
来源
INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES | 2018年 / 5卷 / 12期
关键词
Surgery; Cancer; Risk factors; Perioperative complications; Critical care;
D O I
10.5281/zenodo.1991327
中图分类号
R914 [药物化学];
学科分类号
100701 ;
摘要
Patients undergoing abdominal surgery for solid tumors frequently develop major postoperative complications, which negatively affect quality of life, costs of care and survival. Few studies have identified the determinants of perioperative complications in this group. We performed a prospective observational study including all patients (age > 18) undergoing abdominal surgery for cancer at a single institution between June 2015 and August 2017. Patients undergoing emergency surgery, palliative procedures, or participating in other studies were excluded. Primary outcome was composite of 30-day all-cause mortality and infectious, cardiovascular, respiratory, neurologic, renal and surgical complications. Univariate and multiple logistic regression analyses were performed to identify, predictive factors for major perioperative. adverse events. Of a total 308 included patients, 106 (34.4%) developed a major complication during the 30- day follow-upperiod. Independent predictors of postoperative. major complications were: age (odds ratio [OR] 1.03 [95% CI 1.01-1.06]p = 0.012 per year), ASA (American Society of Anesthesiologists) physical status greater than or equal to 3 (OR 2.61 [95%CI 1.33-5.17] p = 0.003), a preoperative hemoglobin level lower than 12 g/dL (OR 2.13 [95% CI 1.21-4.07] p = 0.014), intraoperutive use of colloids (OR 1.89, [95% CI 1.03-4.07] p = 0.047), total amount of intravenous fluids (OR 1.22 [95% CI0.98-1.59], p = 0.106 per liter), intraoperafive blood losses greater than 500 mL, (2.07 [95% CI 1.00-4.31], p = 0.043), and hypotension needing vasopressor support (OR 4.68 [95% CI 1.55-27.72] p = 0.004). The model had good discrimination with the area under the. ROC curve being 0.80 (95% CI 0.75-0.84, p < 0.001). Our findings suggest that a perioperative strategy aimed at reducing perioperative complications in cancer surgery should include treatment of preoperative anaemia and an optimal fluid strategy, avoiding fluid overload and intraoperative use of colloids.
引用
收藏
页码:14468 / 14475
页数:8
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