Predictive value of risk factors in patients with obstructive jaundice.
Clinical and laboratory parameters that may affect post-operative mortality and morbidity were studied in 215 patients operated on for obstructive jaundice. The cause of the bile duct obstruction was benign disease in 56.7% of patients and malignant disease in 43.3%. Overall postoperative mortality and morbidity rates were 21.9% and 33.5%, respectively. Eight risk factors were shown to be associated with increased mortality: age > 70 years; malignancy; leucocytosis > 15 000 cells/microl and fever > 38.5 degrees C; haematocrit < or = 30%; creatinine > 1.3 mg/dl; albumin < or = 3 g/dl; bilirubin > 20 mg/dl; and serum alkaline phosphatase > 100 IU/l. The simultaneous presence of less than three risk factors was always associated with post-operative survival, but concomitant existence of seven or more risk factors indicated 100% mortality. Understanding the factors related to post-operative morbidity and mortality in patients with obstructive jaundice will better guide appropriate surgical or non-surgical management and lead to improved survival.
Pitiakoudis
M
M
Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Mimidis
K
K
Tsaroucha
A K
AK
Papadopoulos
V
V
Karayiannakis
A
A
Simopoulos
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors