Outcomes in patients with portal hypertension undergoing gastrointestinal surgery: A propensity score matched analysis from the NSQIP dataset
| Autor: | Catherine R. Garcia, Adam Dugan, Roberto Gedaly, Felice De Stefano, Meera Gupta, Lilia Turcios, Francesc Marti |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Databases Factual 03 medical and health sciences 0302 clinical medicine Esophageal varices Text mining Postoperative Complications Hypertension Portal medicine Humans In patient Propensity Score Digestive System Surgical Procedures Aged Aged 80 and over business.industry General Medicine Middle Aged medicine.disease United States Surgery Increased risk 030220 oncology & carcinogenesis Propensity score matching Portal hypertension 030211 gastroenterology & hepatology Female business |
| Zdroj: | American journal of surgery. 217(4) |
| ISSN: | 1879-1883 |
| Popis: | Background/Aim We aim to study the impact of PH in patients undergoing gastrointestinal surgery (GI). Methods We queried the ACS-NSQIP database from 2005 through 2010 for patients undergoing GI surgery with PH. Esophageal varices (EV) diagnosis was used as a surrogate of PH. Results A total of 192,296 patients underwent GI surgery, of which 379 had PH. Regression analyses revealed that patients with PH had a 6-fold (95% CI 4.6–7.9) increase in 30-day mortality, a 3-fold (95% CI 2.5–3.7) increase in morbidity, a 3.2-fold (95% CI 2.6–3.9) increase in critical care complications (CCC), and a 6.5-day (95% CI 5.1–7.8) increase in hospital LOS. After PSM, the impact of PH on the outcomes remained. These differences were significant regardless of the emergent or elective status of the procedure. AUC analysis demonstrated that MELD and MELDNa + score greater than 10.5 was the most predictive of peri-operative mortality in elective PH cases. Conclusions PH is associated with an increased risk of poor surgical outcomes in patients undergoing elective and emergent gastrointestinal surgery. |
| Databáze: | OpenAIRE |
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