계명대학교 의학도서관 Repository

Prediction of Postoperative Mortality in Patients with Organ Failure After Gastric Cancer Surgery

Metadata Downloads
Author(s)
Ji-Ho ParkHyuk-Joon LeeSeung-Young OhShin-Hoo ParkFelix BerlthYoung-Gil SonTae Han KimYeon-Ju HuhJun-Young YangKyung-Goo LeeYun-Suhk SuhSeong-Ho KongHan-Kwang Yang
Publication Year
2020
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.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine (의과대학)
Citation
World Journal of Surgery, Vol.44(5) : 1569-1577, 2020
Type
Article
ISSN
1432-2323
DOI
10.1007/s00268-020-05382-9
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42748
Authorize & License
  • AuthorizeOpen
  • EmbargoForever
Files in This Item:

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.