Charlson comorbidity index predicts anastomotic leakage in patients with resected right-sided colon cancer
Charlson comorbidity index predicts anastomotic leakage in patients with resected right-sided colon cancer
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DOI：
10.1007/s00595-022-02472-0
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发表时间：
2022-02-14
期刊：
影响因子：
2.5
通讯作者：
Nagayasu, Takeshi
中科院分区：
文献类型：
--
作者：
Wada, Hideo;Tominaga, Tetsuro;Nagayasu, Takeshi
目的右半结肠癌术后吻合口漏是影响术后死亡率的严重并发症。据报道，Charlson合并症指数（CCI）是一个有用的预测术后并发症。方法回顾性分析2016 - 2020年593例右半结肠癌手术患者的临床资料。根据有无吻合口瘘将患者分为两组（AL，n = 28;无AL，n = 565）;比较两组的临床病理和手术特征。结果AL组患者的合并症发生率（96.4%）、CCI评分（P <0.001）、出血量（42 mL）、住院时间（30 d）、CCI评分（23 mL）均高于非AL组（P < 0.001）。慢性肺疾病的百分比（14.3% vs. 3.9%，p = 0.029），脑血管疾病（14.3% vs. 1.9%，p = 0.022），结缔组织病AL组中，白血病（39.3% vs. 3.2%，p < 0.001）、白血病（3.6% vs. 0%，p = 0.042）和中度至重度肝病（7.1% vs. 0%，p = 0.002）的发生率显著较高。在多变量分析中，CCI ≥ 2被确定为术后吻合口瘘的独立预测因子（风险比4.91，95%置信区间2.23-10.85，p < 0.001）。结论CCI可预测右半结肠癌术后吻合口瘘。
Purpose Anastomotic leakage after right-sided colon cancer surgery is a serious complication that affects postoperative mortality. The Charlson comorbidity index (CCI) has been reported to be a useful predictor of postoperative complications. Methods A total of 593 cases of right-sided colon cancer resections performed from 2016 to 2020 were examined. The patients were divided into two groups according to the presence or absence of anastomotic leakage (AL, n = 28; no-AL, n = 565); clinicopathological and surgical characteristics were compared between the groups. Results The AL group patients had a higher comorbidity rate (96.4% vs. 66.9%, p < 0.001), higher CCI score (p < 0.001), higher blood loss (42 mL vs. 23 mL, p = 0.046), and longer hospital stay (30 days vs. 12 days, p < 0.001) than the no-AL group patients. The percentages of chronic pulmonary disease (14.3% vs. 3.9%, p = 0.029), cerebrovascular disease (14.3% vs. 1.9%, p = 0.022), connective tissue disease (39.3% vs. 3.2%, p < 0.001), leukemia (3.6% vs. 0%, p = 0.042), and moderate to severe liver disease (7.1% vs. 0%, p = 0.002) were significantly higher in the AL group. In the multivariate analysis, CCI >= 2 was identified as an independent predictor of postoperative anastomotic leakage (hazard ratio 4.91, 95% confidence interval 2.23-10.85, p < 0.001). Conclusions CCI could predict anastomotic leakage after right-sided colon cancer surgery.