ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018
Synergistic Effects of Perioperative Complications on 30-Day Mortality Following Hepatopancreatic Surgery.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Improving hospital quality risk-adjustment models using interactions identified by hierarchical group lasso regularisation.BMC health services research · 2023Article
- Novel Personalized Score Predicts Risk for Postoperative Biliary Leak in Liver Surgery-a Retrospective Database Analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Hidden-mortality risk among patients deemed "low-risk" following high-risk operations.Hepatobiliary surgery and nutrition · 2022Article
- Timing and Severity of Postoperative Complications and Associated 30-Day Mortality Following Hepatic Resection: a National Surgical Quality Improvement Project Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Emergency Department Utilization Following Hepatopancreatic Surgery Among Medicare Beneficiaries.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Complications After Complex Gastrointestinal Cancer Surgery: Benefits and Costs Associated with Inter-hospital Transfer Among Medicare Beneficiaries.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Preoperative Medical Referral Prior to Hepatopancreatic Surgery-Is It Worth it?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Machine learning predicts unpredicted deaths with high accuracy following hepatopancreatic surgery.Hepatobiliary surgery and nutrition · 2021Article
- The Effect of Prone Positioning as Postoperative Physiotherapy to Prevent Atelectasis After Hepatectomy.World journal of surgery · 2020Article
- Use of Machine Learning for Prediction of Patient Risk of Postoperative Complications After Liver, Pancreatic, and Colorectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundData on the interaction effect of multiple concurrent postoperative complications relative to the risk of short-term mortality following hepatopancreatic surgery have not been reported. The objective of the current study was to define the interaction effect of postoperative complications among patients undergoing HP surgery on 30-day mortality.
methodsUsing the ACS-NSQIP Procedure Targeted Participant Use Data File, patients who underwent HP surgery between 2014 and 2016 were identified. Hazard ratios (HRs) for 30-day mortality were estimated using Cox proportional hazard models. Two-way interaction effects assessing combinations of complications relative to 30-day mortality were calculated using the relative excess risk due to interaction (RERI) in separate adjusted Cox models.
resultsAmong 26,824 patients, 10,886 (40.5%) experienced at least one complication. Mortality was higher among patients who experienced at least one complication versus patients who did not experience a complication (3.0 vs 0.1%, p < 0.001). The most common complications were blood transfusion (16.9%, n = 4519), organ space infection (12.2%, n = 3273), and sepsis/septic shock (8.2%, n = 2205). Combinations associated with additive effect on mortality included transfusion + renal dysfunction (RERI 12.3, 95% CI 5.2-19.4), pulmonary dysfunction + renal dysfunction (RERI 60.9, 95% CI 38.6-83.3), pulmonary dysfunction + cardiovascular complication (RERI 144.1, 95% CI 89.3-199.0), and sepsis/septic shock + renal dysfunction (RERI 11.5, 95% CI 4.4-18.7).
conclusionBoth the number and specific type of complication impacted the incidence of postoperative mortality among patients undergoing HP surgery. Certain complications interacted in a synergistic manner, leading to a greater than expected increase in the risk of short-term mortality.
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