Determinants of outcome after colorectal resection within an enhanced recovery programme
| Autor: | K. C. H. Fearon, Jonatan Hausel, Kristoffer Lassen, Cornelis H. C. Dejong, Olle Ljungqvist, Jonas Nygren, P. O. Hendry |
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| Přispěvatelé: | Algemene Heelkunde, RS: NUTRIM - R2 - Gut-liver homeostasis |
| Rok vydání: | 2009 |
| Předmět: |
Male
Reoperation Pediatrics medicine.medical_specialty Colon Severity of Illness Index Postoperative Complications Enhanced recovery Internal medicine Humans Medicine In patient Enhanced recovery after surgery Early Ambulation Aged Colorectal resection Aged 80 and over Postoperative Care business.industry Anastomosis Surgical Age Factors Rectum Nutritional status Recovery of Function Length of Stay Middle Aged medicine.disease Comorbidity Treatment Outcome Feasibility Studies Patient Compliance Female Surgery Colorectal Neoplasms business Body mass index American society of anesthesiologists |
| Zdroj: | British Journal of Surgery, 96(2), 197-205. Wiley |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1002/bjs.6445 |
| Popis: | Background Postoperative outcomes were studied in relation to adverse nutritional risk (body mass index (BMI) below 20 kg/m2), advanced age (80 years or more) and co-morbidity (American Society of Anesthesiologists (ASA) grade III–IV) in patients undergoing colorectal resection within an enhanced recovery after surgery programme. Methods Outcomes were audited prospectively in 1035 patients. Morbidity and mortality were compared with those predicted using the Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity, and a multivariable model was used to determine independent predictors of outcome. Results Postoperative morbidity was lower than predicted (observed to expected 0·68; P < 0·001). Independent predictors of delayed mobilization were ASA III–IV (P < 0·001) and advanced age (P = 0·025). Prolonged hospital stay was related to advanced age (P = 0·002), ASA III–IV (P < 0·001), male sex (P = 0·037) and rectal surgery (P < 0·001). Morbidity was related to ASA III–IV (P = 0·004), male sex (P = 0·023) and rectal surgery (P = 0·002). None of the factors predicted 30-day mortality. Conclusion Age and nutritional status were not independent determinants of morbidity or mortality. Pre-existing co-morbidity was an independent predictor of several outcomes. |
| Databáze: | OpenAIRE |
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