New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study

BMC Surgery

Eiji Hidaka¹  Yosuke Ozawa¹  Itsuki Koganezawa¹  Shigeto Ochiai¹  Takahiro Gunji¹  Toshimichi Kobayashi¹  Kei Yokozuka¹  Shigeyuki Kawachi¹  Toru Sano¹  Satoshi Tabuchi¹  Kosuke Hikita¹  Naokazu Chiba¹  Koichi Tomita¹  Masashi Nakagawa¹ 

[1] Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, 193-0998, Tokyo, Japan;

关键词: Arteriosclerosis;    Elderly;    Gastrointestinal surgery;    Postoperative complication;    Skeletal muscle;   

DOI  :  10.1186/s12893-021-01171-w

来源: Springer

【 摘 要 】

BackgroundGastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group.MethodsThis prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien–Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods.ResultsClavien–Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications.ConclusionsMale sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.

【 授权许可】

CC BY