title: Risk factors associated with delayed haemorrhage after pancreatic resection.
abstract: BACKGROUND
  Delayed haemorrhage (DH) is a life-threatening complication of pancreatic resection (PR) and the mortality rate for DH is very high. However, the risk factors and prognostic factors associated with DH are rarely evaluated.
  
  
  METHODS
  A pancreatic resection was performed on 457 patients. Delayed haemorrhage was defined as bleeding from the surgical site ≥ 5 days after PR. Risk factors for DH were assessed according to demographics and pathological and operative parameters. Prognostic factors after DH were evaluated for the shock index (heart rate/systolic blood pressure) and systemic inflammatory response syndrome (SIRS) scores.
  
  
  RESULTS
  Of the 457 patients, 11 (2.4%) experienced DH after PR. Logistic regression analysis showed that age >60 years and a diagnosis of malignant disease were risk factors for DH. The shock index and SIRS scores at the onset of DH were significantly higher in patients who died as compared with those patients that survived (P < 0.05).
  
  
  CONCLUSIONS
  PR-associated DH carries an increased risk for patients aged >60 years with malignant disease. Prognostic factors were a shock index score ≥ 0.7 and SIRS at the onset of DH.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakahara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kuroki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ikuta
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000401:mortality; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000401:mortality; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult