Postoperative mortality and morbidity in French patients undergoing colorectal surgery - Results of a prospective multicenter study
Postoperative mortality and morbidity in French patients undergoing colorectal surgery - Results of a prospective multicenter study
复制标题
DOI：
10.1001/archsurg.140.3.278
复制
发表时间：
2005-03-01
影响因子：
--
通讯作者：
Slim, K
中科院分区：
文献类型：
--
作者：
Alves, A;Panis, Y;Slim, K
假设：更好地了解独立的危险因素可能会降低死亡率和发病率以下colorectal surgery.Design：前瞻性多中心study.Interventions：从2002年6月至9月，连续患者接受开放或腹腔镜手术（择期或紧急基础上）的结直肠癌或憩室疾病的前瞻性包括。排除标准为其他原因的结肠切除术（如炎症性肠病、良性息肉）。结构化的数据收集表包括200多项关于患者、疾病和手术医生的所有围手术期数据。结果：1421例患者中，住院死亡率为3.4%，总并发症发生率为35%。发现了四个独立的术前死亡风险因素：急诊手术、体重减轻超过10%、神经系统合并症和年龄超过70岁。六个独立的危险因素的发病率被发现：年龄大于70岁，神经系统合并症，低白蛋白血症，心肺合并症，手术时间长，腹膜contamination.Conclusion：大肠切除术在法国与3.4%的死亡率和35%的发病率。了解风险因素可以帮助外科医生处理病例。
Hypothesis: Better knowledge of independent risk factors might decrease mortality and morbidity rates following colorectal surgery.Design: Prospective multicenter study.Interventions: From June to September 2002, consecutive patients undergoing open or laparoscopic surgery (electively or on an emergent basis) for colorectal cancers or diverticular disease were prospectively included. Exclusion criteria were colectomy for other causes (eg, inflammatory bowel diseases, benign polyps). The structured sheet of data collection included more than 200 items on all perioperative data concerning the patient, the disease, and the operating surgeons. Postoperative mortality and morbidity were defined as in-hospital death and complications.Results: Among 1421 patients, the in-hospital death rate was 3.4% and the overall morbidity rate was 35%. Four independent preoperative risk factors of mortality were found: emergency surgery, loss of more than 10% of weight, neurological comorbidity, and age older than 70 years. Six independent risk factors of morbidity were found: age older than 70 years, neurologic comorbidity, hypoalbuminemia, cardiorespiratory comorbidity, long duration of operation, and peritoneal contamination.Conclusion: Colorectal resection in France is associated with a 3.4% mortality rate and a 35% morbidity rate. Knowledge of the risk factors could help surgeons manage cases.