Esophagectomy Surgical Apgar Score May Not Be Associated With Postoperative Morbidity
| Autor: | Yohei Kawasaki, Junichiro Yokoyama, Yoshitaka Aoki, Eriko Morimoto, Futoshi Nakajima, Kazuki Ide, Yoko Fujita |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Blood Loss Surgical 030204 cardiovascular system & hematology Logistic regression Risk Assessment Decision Support Techniques 03 medical and health sciences Postoperative Complications 0302 clinical medicine Heart Rate Predictive Value of Tests Risk Factors hemic and lymphatic diseases medicine Humans Arterial Pressure Aged Retrospective Studies Aged 80 and over Receiver operating characteristic business.industry General Medicine Odds ratio Middle Aged Confidence interval Surgery Esophagectomy Exact test Treatment Outcome 030228 respiratory system Female Apgar score Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | Seminars in Thoracic and Cardiovascular Surgery. 31:574-580 |
| ISSN: | 1043-0679 |
| DOI: | 10.1053/j.semtcvs.2018.12.002 |
| Popis: | This study was performed to investigate the association between the esophagectomy surgical Apgar score (eSAS) and 30-day morbidity after esophagectomy. We retrospectively identified patients who underwent esophagectomy in our facilities database from January 2011 through December 2015. We calculated the eSAS and modified eSAS, which was adjusted for the blood loss volume, according to our patients' data. After estimating the cut-off point of the eSAS using a receiver operating curve, the morbidity rates between the 2 groups were compared using Fisher's exact test. In addition, logistic regression analysis was performed to adjust the results by factors associated with morbidity. In total, 246 patients were included. Of these patients, 144 presented with major morbidity. The optimal cut-off value of the eSAS was 4 points. A total of 145 patients had an eSAS of4 points, and 89 of them developed morbidity. A total of 101 patients had an eSAS of ≥4 points, and 55 of them developed morbidity. Fisher's exact test showed that an eSAS of4 points was not significantly associated with morbidity after esophagectomy (P = 0.29). The association was improved after modification for the blood loss volume (P = 0.004). Multivariable analysis revealed that the modified eSAS and age were significantly associated with morbidity (odds ratio, 0.47 and 1.04, respectively). The validity of the eSAS to predict morbidity after esophagectomy could be low, and the modified blood loss volume may improve the predictive effect. |
| Databáze: | OpenAIRE |
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