Risk Factors Associated With Perioperative Complications and Prolonged Length of Stay After Laparoscopic Adrenalectomy
| Autor: | Insoo Suh, Kathryn Chomsky-Higgins, Carolyn D. Seib, Iheoma Nwaogu, Quan-Yang Duh, Anouk Scholten, Jessica E. Gosnell, Wen T. Shen, Yufei Chen |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Aging Adrenal disorder medicine.medical_treatment Blood Loss Surgical Adrenal Gland Neoplasms Comorbidity 030230 surgery California Cohort Studies 0302 clinical medicine Postoperative Complications Risk Factors Surgical 80 and over Blood Loss Intraoperative Complications Child Cancer Aged 80 and over Academic Medical Centers Age Factors Adrenalectomy Middle Aged Conversion to Open Surgery Child Preschool 030220 oncology & carcinogenesis Cohort Female Patient Safety 6.4 Surgery Cohort study Adult medicine.medical_specialty Adolescent Clinical Trials and Supportive Activities and over Pheochromocytoma 03 medical and health sciences Young Adult Clinical Research medicine Diabetes Mellitus Humans Blood Transfusion Preschool Retrospective Studies Aged business.industry Evaluation of treatments and therapeutic interventions Retrospective cohort study Odds ratio Perioperative Length of Stay medicine.disease Surgery Laparoscopy business |
| Zdroj: | Chen, Y; Scholten, A; Chomsky-Higgins, K; Nwaogu, I; Gosnell, JE; Seib, C; et al.(2018). Risk Factors Associated With Perioperative Complications and Prolonged Length of Stay After Laparoscopic Adrenalectomy.. JAMA surgery. doi: 10.1001/jamasurg.2018.2648. UCSF: Retrieved from: http://www.escholarship.org/uc/item/1865p3b3 JAMA surgery, vol 153, iss 11 |
| DOI: | 10.1001/jamasurg.2018.2648. |
| Popis: | ImportanceLaparoscopic adrenalectomy is the gold standard for most adrenal disorders and its frequency in the United States is increasing. While national and administrative databases can adjust for patient factors, comorbidities, and institutional variations, granular disease-specific data that may significantly influence the incidence of perioperative complications and length of stay (LOS) are lacking.ObjectiveTo investigate factors associated with perioperative complications and LOS after laparoscopic adrenalectomy.Design, setting, and participantsThis cohort study was carried out at a single academic medical center, with all patients who underwent laparoscopic adrenalectomy between 1993 and 2017 by the endocrine surgery department. Multivariable linear and logistic regression were used to obtain adjusted odds ratios (ORs).Main outcomes and measuresThe primary outcome was perioperative complications with a Dindo-Clavien grade of 2 or more. The secondary outcome was prolonged length of stay, defined as a stay longer than the 75th percentile of the overall cohort.ResultsWe identified 640 patients who underwent 653 laparoscopic adrenalectomies, of whom 370 (56.7%) were female. The median age was 51 (range, 5-88) years. A total of 76 complications with a Dindo-Clavien grade of 2 or more occurred in 55 patients (8.4%), with postoperative mortality in 2 patients (0.3%). The median hospital length of stay was 1 day (range, 0-32 days). Factors independently associated with increased complications were American Society of Anesthesiologists class 3 or 4 (OR, 2.78 [95% CI, 1.39-5.55]; P |
| Databáze: | OpenAIRE |
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