Risk factors for postoperative complications after gastrectomy in gastric cancer patients with comorbidities

Takuya Hamakawa, Yukinori Kurokawa, Jota Mikami, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Makoto Yamasaki, Hiroshi Miyata, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
Surgery Today 2016, 46 (2): 224-8

PURPOSE: We conducted this retrospective cohort study to evaluate which preoperative comorbidities and their combinations are most strongly associated with postoperative complications after gastrectomy.

METHODS: We collected data on 214 consecutive patients who underwent gastrectomy for gastric cancer. Preoperative comorbidities were placed into one of ten categories: cardiac, pulmonary, liver, renal, central nervous system, hypertension, diabetes, endocrine/metabolic, vascular, and immune/hematological. The relationship between the number of comorbidities and the incidence of postoperative complications was evaluated.

RESULTS: Among 120 patients (56.1 %) with comorbidities, 48 had a single comorbidity and 72 had multiple (≥2) comorbidities. The incidence of postoperative complications was 45.8 % (33/72) for patients with multiple comorbidities and 23.9 % (34/142) for those with 0 or 1 comorbidity (P = 0.001). Among the ten types of comorbidities, only pulmonary (P = 0.019) and vascular diseases (P = 0.007) were significantly associated with the occurrence of postoperative complications.

CONCLUSION: Patients with multiple comorbidities had a significantly higher incidence of postoperative complications after gastrectomy. Among the comorbidities studied, pulmonary and vascular diseases had the strongest association with postoperative complications.

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