The Impact of Patient Frailty on Readmission Morbidity and Mortality in Women Undergoing Ovarian Cancer Surgery [39H]

e18255 Background: Physicians need to risk-stratify their patients preoperatively to adjust the radicality and the indication of surgery. So far, there are only retrospective and limiting data available. Aim of this study is to evaluate the predictive clinical characteristics such as polypharmacy and Charlson-Comorbidity Index (CCI) for postoperative complications in patients undergoing gynecologic cancer surgery. Methods: This is a prospective cohort study of patients undergoing gynecologic cancer surgery at a tertiary care academic center from October 2015 through January 2017. Surgical complications were graded using validated Clavien-Dindo criteria. Using logistic regression, we identified demographic and predictive clinical characteristics for postoperative complications. Results: Out of the 237 enrolled patients 41(17.3%) experienced a grade≥3b complication. Within 30 days of surgery, 9 (3.8%) patients has died. Charlson Comorbidity index (CCI)> 2(p<0.015, OR 2.33, 95% CI 1.18-4.61), polypharmacy (p<0.001, OR 3.40, 95% CI 1.63-7.10), ASA (p<0.0001, OR 2.98, 95% CI 1.65-5.38), BMI>25kg/m2 (p<0.001, OR 4.25, 95% CI 1.86-9.69), preoperative albumin<3.5 g/dl (p<0.009, OR 3.22, 95% CI 1.33-7.79) and potassium < 3.6 mmol/L (p=0.007, OR 5.11, 95% CI 1.55-16.81) were predictive for complications grade≥3b. A multivariable model included duration of surgery (p=0.012, OR 1.26, 95% CI 1.05-1.52), ASA (p=0.01, OR 2.60, 95% CI 1.20-5.60), preoperative albumin<3.5 g/dl (p=0.028, OR 3.37, 95% CI 1.14-10.00), BMI >25kg/m2 (p=0.009, OR 3.81, 95% CI 1.40-10.35) and potassium < 3.6 mmol/L (p=0.02, OR 3.69, 95% CI 1.20-11.38) was predictive of 30-day Morbidity and Mortality. Age (p=0.49, OR 0.89, 95% CI 0.95-1.02), CCI > 2(p=0.88, OR 1.06, 95% CI 0.42-2.69) and polypharmacy (p=0.65, OR 1.26, 95% CI 0.41-3.98) showed no association for postoperative complications. Conclusions: Only ASA, BMI, preoperative albumin and potassium are associated with severe postoperative complications in patients undergoing gynecologic cancer surgery. Subsequent studies should confirm this result to identify better frail cancer patients.

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The Impact of Obesity on the 30-day Morbidity and Mortality After Surgery for Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000619 ◽

2016 ◽

Vol 26 (2) ◽

pp. 276-281 ◽

Cited By ~ 2

Author(s):

Haider Mahdi ◽

Ahmed A. Alhassani ◽

David Lockhart ◽

Hussain Al-Fatlawi ◽

Andrew Wiechert

Keyword(s):

Ovarian Cancer ◽

Morbidity And Mortality ◽

The Impact

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The Impact of the COVID-19 Pandemic on Gastric Cancer Surgery: A Single-Center Study.

Journal of Medical and Surgical Research ◽

10.46327/msrjg.1.000000000000186 ◽

2021 ◽

pp. 879-885

Author(s):

Afig Gojayev ◽

Cemil Yuksel ◽

Ogun Ersen ◽

Haydar Celasin ◽

Ali Ekrem Unal ◽

...

Keyword(s):

Gastric Cancer ◽

Waiting Times ◽

Cancer Surgery ◽

Morbidity And Mortality ◽

World Health ◽

Study Patient ◽

Gastric Cancer Surgery ◽

Clinicopathological Findings ◽

Significant Difference ◽

The Impact

Introduction: Coronavirus disease 2019 (COVID-19) was declared to be a global pandemic by the World Health Organization on March 11, 2020. The impact on gastric cancer (GC) surgery is unknown. Various reports have shown data indicating that cancer patients with COVID-19 have high morbidity and mortality rates. The choice of surgical procedures and perioperative management of the patients with malignancy has become even more impor¬tant in the COVID-19 pandemic. In this study, we aimed to evaluate the effects of the COVID-19 pandemic on the preopartive, intraoperative, and postoperative findings of patients operated for gastric cancer in our clinic. Materials and Methods: We defined the ‘COVID-19’ period as occurring between 12-03-2020 and 31-08-2020. All the enrolled patients were divided into two groups, pre-COVID-19 group (Pre-CG; 64 cases) and COVID-19 group (CG; 39 cases). A total of 103 patients with gastric cancer were included in this study. Patient characteristics, preoperative, intraoperative, and postoperative clinicopathological findings were compared between groups. Results: The waiting times before admission increased in CG (Pre-CG [6.73±2.85] vs CG [20.61±5.16] ; p<0.001). After admission, the waiting time before surgery was longer in CG (Pre-CG [5.06±3.06] vs CG [6.89±3.32] ; p=0.006). No significant difference was detected between the groups in terms of operation time, surgical procedure, combine organ resection, intraoperative blood transfusion requirment (p values, respectively; p=0.108; p=0.951; p=0.204; p=0.597). Postoperative complications were oesophagojejunostomy leak (3/1) , atelectasis (2/2), duodenal leak (2/2), ileus (3/0), pleural effusion (2/2), and others (1/1), and there was no statistically significant difference between the two groups (p = 0.333). There was no significant difference between the two groups in terms of hospital stay (p = 0.086) and ICU stay (p = 0.989). Conclusion: In this study, it was seen that the COVID-19 pandemic did not affect morbidity and mortality in gastric cancer surgery, but it prolonged admission waiting and operation waiting times. Since there is very little data in the literature regarding the effect of COVID-19 on gastric cancer surgery, our study will guide future studies on this subject. Keywords: COVID-19, Impact, Gastric Cancer, Pandemics, Surgery

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