Park, Ji-Ho, Lee, Hyuk-Joon, Oh, Seung-Young, Park, Shin-Hoo, Berlth, Felix, Son, Young-Gil, Kim, Tae Han, Huh, Yeon-Ju, Yang, Jun-Young, Lee, Kyung-Goo, Suh, Yun-Suhk, Kong, Seong-Ho and Yang, Han-Kwang (2020). Prediction of Postoperative Mortality in Patients with Organ Failure After Gastric Cancer Surgery. World J.Surg., 44 (5). S. 1569 - 1578. NEW YORK: SPRINGER. ISSN 1432-2323

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Abstract

Background Scarce data are available on the characteristics of postoperative organ failure (POF) and mortality after gastrectomy. We aimed to describe the causes of organ failure and mortality related to gastrectomy for gastric cancer and to identify patients with POF who are at a risk of failure to rescue (FTR). Methods The study examined patients with POF or in-hospital mortality in Seoul National University Hospital between 2005 and 2014. We identified patients at a high risk of FTR by analyzing laboratory findings, complication data, intensive care unit records, and risk scoring including Acute Physiology and Chronic Health Evaluation (APACHE) IV, Sequential Organ Failure Assessment (SOFA) score, and Simplified Acute Physiology Score (SAPS) 3 at ICU admission. Results Among the 7304 patients who underwent gastrectomy, 80 (1.1%) were identified with Clavien-Dindo classification (CDC) grade >= IVa. The numbers of patients with CDC grade IVa, IVb, and V were 48 (0.66%), 11 (0.15%), and 21 (0.29%), respectively. Pulmonary failure (43.8%), surgical site complication (27.5%), and cardiac failure (13.8%) were the most common causes of POF and mortality. Cancer progression (100%) and cardiac events (45.5%) showed high FTR rates. In univariate analysis, acidosis, hypoalbuminemia, SOFA, APACHE IV, and SAPS 3 were identified as risk factors for FTR (P < 0.05). Finally, SAPS 3 was identified as an independent predictive factor for FTR. Conclusions Cancer progression and acute cardiac failure were the most lethal causes of FTR. SAPS 3 is an independent predictor of FTR among POF patients after gastrectomy.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Park, Ji-HoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, Hyuk-JoonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oh, Seung-YoungUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Park, Shin-HooUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlth, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Son, Young-GilUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kim, Tae HanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huh, Yeon-JuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yang, Jun-YoungUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, Kyung-GooUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Suh, Yun-SuhkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kong, Seong-HoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yang, Han-KwangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-348118
DOI: 10.1007/s00268-020-05382-9
Journal or Publication Title: World J.Surg.
Volume: 44
Number: 5
Page Range: S. 1569 - 1578
Date: 2020
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-2323
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HOSPITAL MORTALITY; DISTAL GASTRECTOMY; NODAL DISSECTION; RISK MODEL; MORBIDITY; COMPLICATIONS; RESCUE; CLASSIFICATION; IDENTIFICATION; LIVERMultiple languages
SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34811

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