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Ninety-Day and In-hospital Mortalities After Gastrointestinal and Hepatopancreatic Biliary Surgery—a Case Series Analysis

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Abstract

The aim was to do a retrospective analysis and audit of our 90-day and in-hospital mortalities after gastrointestinal and hepatopancreatic biliary surgeries performed in our department and analyze factors predicting them. All patients who underwent gastrointestinal and hepatopancreatic biliary surgery in our department in the last 3 years were evaluated for 90-day postoperative and in-hospital mortalities and various factors affecting them. Categorical values were analyzed using the chi-square test or Fisher’s exact test wherever appropriate. Continuous variables were analyzed using the Student t-test for parametric data and Mann–Whitney U test for nonparametric data after skewness and kurtosis analysis. Multivariate analysis was done using logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Statistical analysis was done using SPSS version 23(IBM). Four hundred and twelve patients underwent gastrointestinal and hepatobiliary surgery in the last 3 years at our institute. Two hundred and twenty-two patients underwent major gastrointestinal and hepatobiliary surgeries in the last 3 years at our institute. Ninety-day all-cause mortality after major surgery was 10.8%, all-cause in-hospital mortality was around 8.5% in major surgery. Ninety-day mortality in elective and emergency surgeries was 6.7% and 22.4%, respectively. In-hospital mortality in elective and emergency surgeries was 4.8% and 18.9%, respectively. There was no 90-day mortality after nonmajor surgery. On multivariate analysis, nontechnical complications and emergency surgery independently predicted 90-day mortality. On multivariate analysis, acute kidney injury, nontechnical complications, and emergency surgeries independently predicted in-hospital mortalities. Nontechnical complications and emergency surgeries are independently associated with 90-day mortality, and acute kidney injury, nontechnical complications, and emergency surgery independently predict in-hospital mortality.

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References

  1. Fecho K, Lunney AT, Boysen PG, Rock P, Norfleet EA (2008) Postoperative mortality after inpatient surgery: incidence and risk factors. Ther Clin Risk Manag 4(4):681–688. https://doi.org/10.2147/tcrm.s2735

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jakobson T, Karjagin J, Vipp L et al (2014) Postoperative complications and mortality after major gastrointestinal surgery. Medicina (Kaunas) 50(2):111–117

    Article  Google Scholar 

  3. Lui CW, Boyle FM, Wysocki AP et al (2017) How participation in surgical mortality audit impacts surgical practice. BMC Surg. 17(1):42. https://doi.org/10.1186/s12893-017-0240-z (Published 2017 Apr 19)

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mehta RL, Kellum JA, Shah SV et al (2007) Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11(2):R31

    Article  Google Scholar 

  5. Kellum JA (2015) Diagnostic criteria for acute kidney injury: present and future. Crit Care Clin 31(4):621–632

    Article  Google Scholar 

  6. Bijker JB, van Klei WA, Kappen TH et al (2007) Incidence of intraoperative hypotension as a function of the chosen definition: literature definitions applied to a retrospective cohort using automated data collection. Anesthesiology 107(2):213–220

    Article  Google Scholar 

  7. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD et al (2012) Acute respiratory distress syndrome: the Berlin definition. JAMA 307(23):2526–2533

    Google Scholar 

  8. Ng-Kamstra JS, Arya S, Greenberg SLM, Kotagal M et al (2018) Perioperative mortality rates in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Glob Health 3(3):e000810. https://doi.org/10.1136/bmjgh-2018-000810

    Article  PubMed  PubMed Central  Google Scholar 

  9. Marino MV, Mituś JW, Vaccarella G et al (2020) Complications profile after robotic pancreatic surgery. Państwo i Społeczeństwo 2:51–63. https://doi.org/10.34697/2451-0858-pis-2020-1-004

    Article  Google Scholar 

  10. Csikesz NG, Simons JP, Tseng JF et al (2008) Surgical specialization and operative mortality in hepato-pancreatico-biliary (HPB) surgery. J Gastrointest Surg 12(9):1534–1539. https://doi.org/10.1007/s11605-008-0566-z

    Article  PubMed  Google Scholar 

  11. Kneuertz PJ, Pitt HA, Bilimoria KY et al (2012) Risk of morbidity and mortality following hepato-pancreato-biliary surgery. J Gastrointest Surg 16(9):1727–1735. https://doi.org/10.1007/s11605-012-1938-y

    Article  PubMed  Google Scholar 

  12. Sørensen LT, Malaki A, Wille-Jørgensen P et al (2007) Risk factors for mortality and postoperative complications after gastrointestinal surgery. J Gastrointest Surg 11(7):903–910

    Article  Google Scholar 

  13. Ray S, Mehta NN, Mangla V et al (2019) A comparison between the comprehensive complication index and the Clavien-Dindo grading as a measure of postoperative outcome in patients undergoing gastrointestinal surgery-a prospective study. J Surg Res 244:417–424

    Article  Google Scholar 

  14. Mayo SC, Shore AD, Nathan H et al (2011) Refining the definition of perioperative mortality following hepatectomy using death within 90 days as the standard criterion. HPB (Oxford) 13(7):473–482

    Article  Google Scholar 

  15. Hyer JM, Beane JD, Spolverato G et al (2021) Trends in textbook outcomes over time: are optimal outcomes following complex gastrointestinal surgery for cancer increasing? J Gastrointest Surg. https://doi.org/10.1007/s11605-021-05129-4 (published online ahead of print, 2021 Sep 10)

    Article  PubMed  Google Scholar 

  16. Miskovic A, Lumb AB (2017) Postoperative pulmonary complications. Br J Anaesth 118(3):317–334. https://doi.org/10.1093/bja/aex002

    Article  CAS  PubMed  Google Scholar 

  17. Gameiro J, Fonseca JA, Neves M et al (2018) Acute kidney injury in major abdominal surgery: incidence, risk factors, pathogenesis, and outcomes. Ann Intensive Care 8(1):22. https://doi.org/10.1186/s13613-018-0369-7

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Bhavin Vasavada.

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Vasavada, B., Patel, H. Ninety-Day and In-hospital Mortalities After Gastrointestinal and Hepatopancreatic Biliary Surgery—a Case Series Analysis. Indian J Surg 84 (Suppl 2), 541–545 (2022). https://doi.org/10.1007/s12262-022-03286-7

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  • DOI: https://doi.org/10.1007/s12262-022-03286-7

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