A Scoring System to Predict the Risk of Postoperative Complications After Laparoscopic Gastrectomy for Gastric Cancer Based on a Large-Scale Retrospective Study. Issue 17 (May 2015)

• Record Type: Journal Article
• Authors: Huang, Chang-Ming; Tu, Ru-Hong; Lin, Jian-Xian; Zheng, Chao-Hui; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lu, Jun; Chen, Qi-Yue; Cao, Long-Long; Lin, Mi; Zhang., Yong
• Is Part Of: Medicine. Volume 94:Issue 17(2015)
• Publication Date: 2015-05
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000000812
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>To investigate the risk factors for postoperative complications following laparoscopic gastrectomy (LG) for gastric cancer and to use the risk factors to develop a predictive scoring system.</p> <p>Few studies have been designed to develop scoring systems to predict complications after LG for gastric cancer.</p> <p>We analyzed records of 2170 patients who underwent a LG for gastric cancer. A logistic regression model was used to identify the determinant variables and develop a predictive score.</p> <p>There were 2170 patients, of whom 299 (13.8%) developed overall complications and 78 (3.6%) developed major complications. A multivariate analysis showed the following adverse risk factors for overall complications: age ≥65 years, body mass index (BMI) ≥ 28 kg/m<sup>2</sup>, tumor with pyloric obstruction, tumor with bleeding, and intraoperative blood loss ≥75 mL; age ≥65 years, a Charlson comorbidity score ≥3, tumor with bleeding and intraoperative blood loss ≥75 mL were identified as independent risk factors for major complications. Based on these factors, the authors developed the following predictive score: low risk (no risk factors), intermediate risk (1 risk factor), and high risk (≥2 risk factors). The overall complication rates were 8.3%, 15.6%, and 29.9% for the low-, intermediate-, and high-risk categories, respectively (<italic>P</italic> < 0.001); the major complication rates in the 3 respective groups were 1.2%, 4.7%, and 10.0% (<italic>P</italic> < 0.001).</p> <p>This simple scoring system could accurately predict the risk of postoperative complications after LG for gastric cancer. The score might be helpful in the selection of risk-adapted interventions to improve surgical safety.</p> </sec> </abstract>