New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study.
Arteriosclerosis
Elderly
Gastrointestinal surgery
Postoperative complication
Skeletal muscle
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
30 Mar 2021
30 Mar 2021
Historique:
received:
07
02
2021
accepted:
19
03
2021
entrez:
31
3
2021
pubmed:
1
4
2021
medline:
7
4
2021
Statut:
epublish
Résumé
Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group. This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien-Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods. Clavien-Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications. Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.
Sections du résumé
BACKGROUND
BACKGROUND
Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group.
METHODS
METHODS
This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien-Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods.
RESULTS
RESULTS
Clavien-Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications.
CONCLUSIONS
CONCLUSIONS
Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.
Identifiants
pubmed: 33784994
doi: 10.1186/s12893-021-01171-w
pii: 10.1186/s12893-021-01171-w
pmc: PMC8011193
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
173Subventions
Organisme : Daiwa Securities Co., Ltd, Japan
ID : 46th Research Grant
Organisme : Grant-in-Aid for Scientific Research, Japan
ID : 16K10440
Références
Clin Interv Aging. 2019 Apr 26;14:735-742
pubmed: 31114178
Colorectal Dis. 2018 Aug;20(8):O215-O225
pubmed: 29897171
Surg Endosc. 2017 Jun;31(6):2509-2519
pubmed: 27699515
Ann Surg. 2011 Jun;253(6):1223-9
pubmed: 21412145
Science. 1985 Jan 18;227(4684):257-61
pubmed: 3871252
Surgery. 2015 Jun;157(6):1088-98
pubmed: 25799468
Colorectal Dis. 2019 Oct;21(10):1192-1205
pubmed: 31162882
Biomed Pharmacother. 2004 Oct;58 Suppl 1:S95-8
pubmed: 15754845
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Colorectal Dis. 2018 Sep;20 Suppl 6:69-89
pubmed: 30255643
J Trauma. 1998 Jan;44(1):78-85
pubmed: 9464752
Biosci Trends. 2016 Sep 5;10(4):300-6
pubmed: 27396698
Br J Surg. 2013 Oct;100(11):1523-30
pubmed: 24037576
J Atheroscler Thromb. 2006 Apr;13(2):101-7
pubmed: 16733298
J Geriatr Oncol. 2020 Mar;11(2):244-255
pubmed: 31492572
Am J Transplant. 2013 Jun;13(6):1549-56
pubmed: 23601159
J Am Med Dir Assoc. 2014 Feb;15(2):95-101
pubmed: 24461239
Curr Hypertens Rev. 2013 Feb;9(1):66-75
pubmed: 23807874
Value Health. 2009 Jun;12(4):568-73
pubmed: 18783391
Surg Endosc. 2018 Jan;32(1):358-366
pubmed: 28656334
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912