A scoring system to predict the risk of postoperative complications after laparoscopic gastrectomy for gastric cancer based on a large-scale retrospective study.
To investigate the risk factors for postoperative complications following laparoscopic gastrectomy (LG) for gastric cancer and to use the risk factors to develop a predictive scoring system.Few studies have been designed to develop scoring systems to predict complications after LG for gastric cancer.We analyzed records of 2170 patients who underwent a LG for gastric cancer. A logistic regression model was used to identify the determinant variables and develop a predictive score.There were 2170 patients, of whom 299 (13.8%) developed overall complications and 78 (3.6%) developed major complications. A multivariate analysis showed the following adverse risk factors for overall complications: age ≥65 years, body mass index (BMI) ≥ 28 kg/m, tumor with pyloric obstruction, tumor with bleeding, and intraoperative blood loss ≥75 mL; age ≥65 years, a Charlson comorbidity score ≥3, tumor with bleeding and intraoperative blood loss ≥75 mL were identified as independent risk factors for major complications. Based on these factors, the authors developed the following predictive score: low risk (no risk factors), intermediate risk (1 risk factor), and high risk (≥2 risk factors). The overall complication rates were 8.3%, 15.6%, and 29.9% for the low-, intermediate-, and high-risk categories, respectively (P < 0.001); the major complication rates in the 3 respective groups were 1.2%, 4.7%, and 10.0% (P < 0.001).This simple scoring system could accurately predict the risk of postoperative complications after LG for gastric cancer. The score might be helpful in the selection of risk-adapted interventions to improve surgical safety.
From the Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.
Chang-Ming
CM
Huang
Ru-Hong
RH
Tu
Jian-Xian
JX
Lin
Chao-Hui
CH
Zheng
Ping
P
Li
Jian-Wei
JW
Xie
Jia-Bin
JB
Wang
Jun
J
Lu
Qi-Yue
QY
Chen
Long-Long
LL
Cao
Mi
M
Lin
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*