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Ventilation after pancreaticoduodenectomy increases perioperative mortality: Identification of risk factors and their relevance in Germany that do not apply in England

引用

Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 379-388页

作者： Rieke-Sophie Homeyer keith jroberts Robert P Sutcliffe Alexander Kaltenborn Darius Mirza Zhi Qu Jurgen Klempnauer Harald Schrem Core Facility Quality Management Transplantation Integrated Research and Treatment Center Transplantation(IFB-Tx)Hannover Medical SchoolCarl-Neuberg-Str.130625 HannoverGermany General Visceral and Transplant SurgeryHannover Medical SchoolCarl-Neuberg-Str.130625 HannoverGermany Department of HPB Surgery Queen Elizabeth Hospital BirminghamMindelsohn Way EdgbastonBirmingham B15 2GWUnited Kingdom Department of General Visceral and Transplant SurgeryMedical University GrazAuenbrugger Platz 58036 GrazAustria

Background:Pre-operative risk factors for post-operative ventilation and their influence on survival after pancreaticoduodenectomy for malignancy are ***:Totally 391 patients operated in Hannover,Germany were investigated with multivariable logistic regression and Cox regression modeling to identify independent risk factors for post-operative ventilation≥6 h,patient survival and 90-day *** 84 patients operated in Birmingham,United Kingdom were analyzed to assess the external relevance of ***:Longer operations,history of thrombosis,intra-operative blood transfusion,lower estimated glomerular filtration rates(eGFR)and higher values of the age at operation divided by the Horovitz Quotient independently increased the risk of post-operative ventilation≥6 h in German patients(n=108;27.6%)(P75 years,had a history of thrombosis,received blood transfusions,and had significantly worse lung function ***4 tumors were detected in 18 German patients(4.6%),but not in the English ***:Identified risk factors for post-operative ventilation are clinically relevant in Germany but not in England and may be used to lower mortality *** German and the English cohorts displayed significant differences in the approach to patient selection and early post-operative extubation.

关键词： Pancreatic cancer Cholangiocellular carcinoma Periampullary carcinoma Comorbidity Outcome

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