Prognostic factors for postoperative complications after K-wire fixation for paediatric forearm fractures

Abstract Aim To investigate the impact of malnutrition on postoperative complications in esophageal cancer patients. Background and Methods Malnutrition is common in esophageal cancer patients due to the debilitating nature of their disease. Several methods of nutritional assessment have emerged as significant prognostic factors for short-and long-term outcomes in patients operated for esophageal cancer. The study sample consisted of 85 patients with esophageal (n=11) and gastroesophageal junction (n=74) cancer who were admitted for surgery in the First Department of Surgery, Laikon General Hospital, Athens, Greece, between September 2015 and March 2019. Out of them, 65 patients underwent esophagectomy, while 20 patients underwent total gastrectomy. The assessment of nutritional status included the Geriatric Nutritional Risk Index (GNRI), the Patient Generated Subjective Global Assessment (PG-SGA) and sarcopenia. GNRI was based on preoperative values of patients’ serum albumin and body weight. The preoperative assessment of sarcopenia was based on Skeletal Muscle Index (SMI) derived from analysis of CT scans using SliceOmatic® Software version 4.3 (Tomovision, Montreal, Canada). Postoperative complications were graded according to Clavien-Dindo classification. Minor complications included categories I-II, whereas major complications included categories III-V. Results Thirty nine patients (47.6%) developed postoperative complications. More specifically, 21 patients (24.7%) developed minor complications and 18 patients (21.2%) developed major complications, while anastomotic leakage occurred in 10 patients (11.8%). Eighty patients (94.1%) had a high-risk GNRI (<92), while 5 patients (5.9%) had a low-risk GNRI (≥92). Forty four patients (51.8%) were diagnosed with sarcopenia. The mean PG-SGA score was 8.82 ± 5.57. Patients with a high-risk GNRI demonstrated significantly higher rate of overall complications compared to low-risk GNRI patients (100% vs 44.2%, p<0.05 respectively). Moreover, the rate of anastomotic leakage was significantly higher in the sarcopenia group than in the non-sarcopenia group (29% vs 3.4%, p<0.05). Nonetheless, PG-SGA was not significantly associated with postoperative outcomes. Conclusion Higher-risk scores on the GNRI are associated with an increased risk for developing postoperative complications, while sarcopenia is associated with higher risk for anastomotic leakage among esophageal cancer patients. Preoperative assessment of GNRI and sarcopenia should be performed in all patients in order to detect patients who are at greater risk of postoperative morbidity.

Download Full-text

Preoperative leukocytosis and the resection severity index are independent risk factors for survival in patients with intrahepatic cholangiocarcinoma

Langenbeck s Archives of Surgery ◽

10.1007/s00423-020-01962-4 ◽

2020 ◽

Vol 405 (7) ◽

pp. 977-988

Author(s):

Oliver Beetz ◽

Clara A. Weigle ◽

Sebastian Cammann ◽

Florian W. R. Vondran ◽

Kai Timrott ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

Postoperative Complications ◽

Intrahepatic Cholangiocarcinoma ◽

Postoperative Morbidity ◽

Severity Index ◽

The Body ◽

Morbidity And Mortality ◽

Independent Risk Factors ◽

Risk Factors For Survival

Abstract Purpose The incidence of intrahepatic cholangiocarcinoma is increasing worldwide. Despite advances in surgical and non-surgical treatment, reported outcomes are still poor and surgical resection remains to be the only chance for long-term survival of affected patients. The identification and validation of prognostic factors and scores, such as the recently introduced resection severity index, for postoperative morbidity and mortality are essential to facilitate optimal therapeutic regimens. Methods This is a retrospective analysis of 269 patients undergoing resection of histologically confirmed intrahepatic cholangiocarcinoma between February 1996 and September 2018 at a tertiary referral center for hepatobiliary surgery. Regression analyses were performed to evaluate potential prognostic factors, including the resection severity index. Results Median postoperative follow-up time was 22.93 (0.10–234.39) months. Severe postoperative complications (≥ Clavien-Dindo grade III) were observed in 94 (34.9%) patients. The body mass index (p = 0.035), the resection severity index (ASAT in U/l divided by Quick in % multiplied by the extent of liver resection graded in points; p = 0.006), additional hilar bile duct resection (p = 0.005), and number of packed red blood cells transfused during operation (p = 0.036) were independent risk factors for the onset of severe postoperative complications. Median Kaplan-Meier survival after resection was 27.63 months. Preoperative leukocytosis (p = 0.003), the resection severity index (p = 0.005), multivisceral resection (p = 0.001), and T stage ≥ 3 (p = 0.013) were identified as independent risk factors for survival. Conclusion Preoperative leukocytosis and the resection severity index are useful variables for preoperative risk stratification since they were identified as significant predictors for postoperative morbidity and mortality, respectively.

Download Full-text

Percutaneous Transphyseal Intramedullary K-wire Fixation for the Diaphyseal Forearm Fractures in Children

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2006.19.3.374 ◽

2006 ◽

Vol 19 (3) ◽

pp. 374

Author(s):

Jung Hoei Ku ◽

Young Chul Go ◽

Man Jun Park

Keyword(s):

Forearm Fractures ◽

Fractures In Children ◽

Wire Fixation

Download Full-text

Age, Neurological Status MRC Scale, and Postoperative Morbidity are Prognostic Factors in Patients with Glioblastoma Treated by Chemoradiotherapy

Clinical Medicine Insights Oncology ◽

10.4137/cmo.s38474 ◽

2016 ◽

Vol 10 ◽

pp. CMO.S38474 ◽

Cited By ~ 3

Author(s):

Clotilde Verlut ◽

Guillaume Mouillet ◽

Eloi Magnin ◽

Joëlle Buffet-Miny ◽

Gabriel Viennet ◽

...

Keyword(s):

Prognostic Factors ◽

Postoperative Complications ◽

Postoperative Morbidity ◽

Medical Research Council ◽

Neurological Status ◽

Factors Associated ◽

Newly Diagnosed Glioblastoma ◽

Patient Prognosis ◽

Radiotherapy Treatment ◽

Concomitant Radiotherapy

Introduction Temozolomide and concomitant radiotherapy followed by temozolomide has been used as a standard therapy for the treatment of newly diagnosed glioblastoma multiform since 2005. A search for prognostic factors was conducted in patients with glioblastoma routinely treated by this strategy in our institution. Methods This retrospective study included all patients with histologically proven glioblastoma diagnosed between June 1, 2005, and January 1, 2012, in the Franche-Comté region and treated by radiotherapy (daily fractions of 2 Gy for a total of 60 Gy) combined with temozolomide at a dose of 75 mg/m2 per day, followed by six cycles of maintenance temozolomide (150–200 mg/m2, five consecutive days per month). The primary aim was to identify prognostic factors associated with overall survival (OS) in this cohort of patients. Results One hundred three patients were included in this study. The median age was 64 years. The median OS was 13.7 months (95% confidence interval, 12.5–15.9 months). In multivariate analysis, age over 65 years (hazard ratio [HR] = 1.88; P = 0.01), Medical Research Council (MRC) scale 3–4 (HR = 1.62; P = 0.038), and occurrence of postoperative complications (HR = 2.15; P = 0.028) were associated with unfavorable OS. Conclusions This study identified three prognostic factors in patients with glioblastoma eligible to the standard chemotherapy and radiotherapy treatment. Age over 65 years, MRC scale 3–4, and occurrence of postoperative complications were associated with unfavorable OS. A simple clinical evaluation including these three factors enables to estimate the patient prognosis. MRC neurological scale could be a useful, quick, and simple measure to assess neurological status in glioblastoma patients.

Download Full-text

Pre- and postoperative complications of adult forearm fractures treated with plate fixation

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2016.04.014 ◽

2016 ◽

Vol 102 (6) ◽

pp. 781-784 ◽

Cited By ~ 4

Author(s):

P.-S. Marcheix ◽

S. Delclaux ◽

M. Ehlinger ◽

B. Scheibling ◽

F. Dalmay ◽

...

Keyword(s):

Postoperative Complications ◽

Plate Fixation ◽

Forearm Fractures

Download Full-text

ANALYSIS OF COMPLICATIONS IN ELIMINATION OF THE COLOSTOMY AFTER HARTMANN SURGERY

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2016-175-5-69-73 ◽

2016 ◽

Vol 175 (5) ◽

pp. 69-73

Author(s):

V. I. Pomazkin

Keyword(s):

Risk Factors ◽

Colon Cancer ◽

Prognostic Factors ◽

Postoperative Complications ◽

The Third ◽

Early Postoperative Complications ◽

Reconstructive Operations ◽

End Colostomy ◽

Adhesion Process ◽

Made In

An analysis of early postoperative complications was made in reconstructive surgery on the colon in case of the end colostomy in patients with left-half colon cancer complicated by intestinal obstruction. This work investigated the prognostic factors, which could influence on incidence of complications. The research included results of reconstructive operations in 192 patients. The early postoperative complications were noted in 18 (9,4%) patients. The univariant analysis of risk factors showed, that the presence COPD increased the possibility of complication incidence in 1,7 times (p=0,044). The incidence of purulent complications on previous stage of treatment increased complications in 4,3 times (p=0,011) and the third degree of adhesions process intensity compared with the first degree - in 9,7 times (p=0,001). The multivariant analysis demonstrated a correlation of the complication risks in reconstructive operations with presence of complications on the previous stage of treatment. This correlation was 4,3 (CI 1,7-23,3; p=0,021) and it consisted of 7, 5 (CI 1,3-15,6; p=0,001) in case of presence of the third degree of adhesion process.

Download Full-text