New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study
Abstract Background Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation syst...
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doaj-98742f53420346368d01f719f1a249a62021-04-04T11:22:34ZengBMCBMC Surgery1471-24822021-03-012111810.1186/s12893-021-01171-wNew risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort studyKei Yokozuka0Koichi Tomita1Masashi Nakagawa2Itsuki Koganezawa3Shigeto Ochiai4Takahiro Gunji5Yosuke Ozawa6Kosuke Hikita7Toshimichi Kobayashi8Toru Sano9Satoshi Tabuchi10Naokazu Chiba11Eiji Hidaka12Shigeyuki Kawachi13Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterAbstract Background Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group. Methods This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien–Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods. Results Clavien–Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications. Conclusions Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.https://doi.org/10.1186/s12893-021-01171-wArteriosclerosisElderlyGastrointestinal surgeryPostoperative complicationSkeletal muscle |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kei Yokozuka Koichi Tomita Masashi Nakagawa Itsuki Koganezawa Shigeto Ochiai Takahiro Gunji Yosuke Ozawa Kosuke Hikita Toshimichi Kobayashi Toru Sano Satoshi Tabuchi Naokazu Chiba Eiji Hidaka Shigeyuki Kawachi |
spellingShingle |
Kei Yokozuka Koichi Tomita Masashi Nakagawa Itsuki Koganezawa Shigeto Ochiai Takahiro Gunji Yosuke Ozawa Kosuke Hikita Toshimichi Kobayashi Toru Sano Satoshi Tabuchi Naokazu Chiba Eiji Hidaka Shigeyuki Kawachi New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study BMC Surgery Arteriosclerosis Elderly Gastrointestinal surgery Postoperative complication Skeletal muscle |
author_facet |
Kei Yokozuka Koichi Tomita Masashi Nakagawa Itsuki Koganezawa Shigeto Ochiai Takahiro Gunji Yosuke Ozawa Kosuke Hikita Toshimichi Kobayashi Toru Sano Satoshi Tabuchi Naokazu Chiba Eiji Hidaka Shigeyuki Kawachi |
author_sort |
Kei Yokozuka |
title |
New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study |
title_short |
New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study |
title_full |
New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study |
title_fullStr |
New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study |
title_full_unstemmed |
New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study |
title_sort |
new risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study |
publisher |
BMC |
series |
BMC Surgery |
issn |
1471-2482 |
publishDate |
2021-03-01 |
description |
Abstract Background Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group. Methods This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien–Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods. Results Clavien–Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications. Conclusions Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management. |
topic |
Arteriosclerosis Elderly Gastrointestinal surgery Postoperative complication Skeletal muscle |
url |
https://doi.org/10.1186/s12893-021-01171-w |
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