Identification of Candidates for Early Discharge After Gastrectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-01

AUTHORS

Ji-Ho Park, Young-Gil Son, Tae-Han Kim, Yeon-Ju Huh, Jun-Young Yang, Yong-Joon Suh, Yun-Suhk Suh, Seong-Ho Kong, Hyuk-Joon Lee, Han-Kwang Yang

ABSTRACT

OBJECTIVE: The aim of this study was to analyze clinical and laboratory variables associated with complications after gastrectomy for gastric cancer to predict candidates for successful early discharge. METHODS: Consecutive patients undergoing gastrectomy at Seoul National University Hospital from January through December 2013 were identified from a prospective complications database. Clinicopathologic and postoperative laboratory parameters were analyzed to determine variables associated with complications. An additional validation study was performed from March through May 2014. RESULTS: Overall, complications occurred in 180/855 patients (21.1 %). Age >68 years (odds ratio [OR] 1.64), use of an open approach (OR 1.9), and use of combined resection (OR 1.67) were significant independent risk factors for complications (p < 0.05). The postoperative day (POD) 5 to preoperative white blood cell count (WBC) ratio (risk ratio [RR] 2.01), C-reactive protein (CRP) level on POD 5 (RR 1.1), and maximum body temperature on POD 4 (RR 2.36) independently predicted complications in a multivariate analysis (p < 0.05). After establishing an early discharge profile (EDP) based on these six variables, 152/855 patients (17.8 %) were predicted to have an uncomplicated course. Of these, 8/152 (5.3 %) experienced complications. In a validation study of 217 patients, 43/217 (19.8 %) were candidates for early discharge on POD 5, and 3 (7.0 %) had a false-positive EDP. CONCLUSIONS: Patients younger than 68 years of age who underwent laparoscopic gastrectomy without combined resection might be candidates for early discharge on POD 5 if the POD 5 to preoperative WBC ratio is ≤1.2, POD 5 CRP level is ≤5.38 g/mL, and POD 4 body temperature is ≤37.4 °C. More... »

PAGES

159-166

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1245/s10434-016-5447-1

    DOI

    http://dx.doi.org/10.1245/s10434-016-5447-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1008354263

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27448119


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