TY - JOUR
T1 - In-hospital clinical outcomes after upper gastrointestinal surgery
T2 - Data from an international observational study
AU - Int Surgical Outcomes Study ISOS
AU - Ahmad, T.
AU - Bouwman, R. A.
AU - Grigoras, I.
AU - Aldecoa, C.
AU - Hofer, C.
AU - Hoeft, A.
AU - Holt, P.
AU - Fleisher, L. A.
AU - Buhre, W.
AU - Pearse, R. M.
AU - Ferguson, Marissa
AU - MacMahon, Michael
AU - Shulman, Mark
AU - Cherian, Ritchie
AU - Currow, Helen
AU - Kanathiban, Kathirgamanathan
AU - Gillespie, David
AU - Pathmanathan, Edward
AU - Phillips, Katherine
AU - Reynolds, Jenifer
AU - Rowley, Joanne
AU - Douglas, Jeanene
AU - Kerridge, Ross
AU - Garg, Sameer
AU - Bennett, Michael
AU - Jain, Megha
AU - Alcock, David
AU - Terblanche, Nico
AU - Cotter, Rochelle
AU - Leslie, Kate
AU - Stewart, Marcelle
AU - Zingerle, Nicolette
AU - Clyde, Antony
AU - Hambidge, Oliver
AU - Rehak, Adam
AU - Cotterell, Sharon
AU - Huynh, Wilson Binh Quan
AU - McCulloch, Timothy
AU - Ben-Menachem, Erez
AU - Egan, Thomas
AU - Cope, Jennifer
AU - Halliwell, Richard
AU - Fellinger, Paul
AU - Haisjackl, Markus
AU - Haselberger, Simone
AU - Holaubek, Caroline
AU - Lichtenegger, Paul
AU - Scherz, Florian
AU - Schmid, Werner
AU - Spanjersberg, Rob
PY - 2017/12
Y1 - 2017/12
N2 - Aims: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level.Methods: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal. surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals.Results: 2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]).Conclusions: Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk. (C) 2017 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
AB - Aims: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level.Methods: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal. surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals.Results: 2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]).Conclusions: Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk. (C) 2017 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
KW - Postoperative care
KW - Complication rate
KW - Upper gastrointestinal surgery
KW - Oesophagectomy
KW - Mortality
KW - Cancer
KW - MORTALITY FOLLOWING ESOPHAGECTOMY
KW - LONG-TERM SURVIVAL
KW - ENHANCED RECOVERY
KW - SURGICAL COMPLICATIONS
KW - PERIOPERATIVE MEDICINE
KW - ESOPHAGOGASTRIC CANCER
KW - RISK
KW - MORBIDITY
KW - IMPACT
KW - CARE
U2 - 10.1016/j.ejso.2017.08.002
DO - 10.1016/j.ejso.2017.08.002
M3 - Article
SN - 0748-7983
VL - 43
SP - 2324
EP - 2332
JO - EJSO
JF - EJSO
IS - 12
ER -