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Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center
We investigate the surgical outcomes of patients undergoing hepatectomy according to different age intervals, identify the clinical factors related to surgical outcomes, and propose clinical risk scores for severe morbidity and mortality based on the clinical factors. Eight hundred three patients un...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440154/ https://www.ncbi.nlm.nih.gov/pubmed/28514317 http://dx.doi.org/10.1097/MD.0000000000006955 |
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author | Ruzzenente, Andrea Conci, Simone Ciangherotti, Andrea Campagnaro, Tommaso Valdegamberi, Alessandro Bertuzzo, Francesca Bagante, Fabio Mantovani, Guido De Angelis, Michela Dorna, Adriano E. Piccino, Marco Pedrazzani, Corrado Guglielmi, Alfredo Iacono, Calogero |
author_facet | Ruzzenente, Andrea Conci, Simone Ciangherotti, Andrea Campagnaro, Tommaso Valdegamberi, Alessandro Bertuzzo, Francesca Bagante, Fabio Mantovani, Guido De Angelis, Michela Dorna, Adriano E. Piccino, Marco Pedrazzani, Corrado Guglielmi, Alfredo Iacono, Calogero |
author_sort | Ruzzenente, Andrea |
collection | PubMed |
description | We investigate the surgical outcomes of patients undergoing hepatectomy according to different age intervals, identify the clinical factors related to surgical outcomes, and propose clinical risk scores for severe morbidity and mortality based on the clinical factors. Eight hundred three patients undergoing liver resection were divided into 3 groups: young patients (YP), <65 years (n = 387), elderly patients (EP), from 65 to 74 years (n = 279); very-elderly patients (VEP), ≥75 years (n = 137). Severe morbidity was 10.6%, 12.2%, and 17.5% (P = .103), and mortality was 0.3%, 1.4%, and 4.4% (P = .002) in group YP, EP, and VEP, respectively. Ischemic heart disease, cirrhosis, major hepatectomy, biliary tract-associated procedure, and red blood cells (RBC) transfusion ≥3 U were related with severe morbidity. Ischemic heart disease, cirrhosis, major hepatectomy, and RBC transfusion were independent risk factors for postoperative mortality. Age did not result an independent factor related to mortality and severe morbidity. Two different scores were developed and have proved to be statistically related with severe morbidity and mortality. Moreover, in patients with score ≥2, severe morbidity increased from 24.2% in YP, to 29.3% in EP, and to 40.0% in VEP, P = .047. Likewise, mortality increased from 2.3% in YP, to 7.0% in EP, and to 22.7% in VEP, in patients with score ≥2, P = .017. Age alone should not be considered a contraindication for hepatectomy. We identified factors and proposed 2 scores that can be useful to stratify the risk of morbidity and mortality after hepatectomy. Moreover, severe morbidity and mortality increases according to the different age intervals in patients with scores ≥2. |
format | Online Article Text |
id | pubmed-5440154 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-54401542017-05-25 Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center Ruzzenente, Andrea Conci, Simone Ciangherotti, Andrea Campagnaro, Tommaso Valdegamberi, Alessandro Bertuzzo, Francesca Bagante, Fabio Mantovani, Guido De Angelis, Michela Dorna, Adriano E. Piccino, Marco Pedrazzani, Corrado Guglielmi, Alfredo Iacono, Calogero Medicine (Baltimore) 7100 We investigate the surgical outcomes of patients undergoing hepatectomy according to different age intervals, identify the clinical factors related to surgical outcomes, and propose clinical risk scores for severe morbidity and mortality based on the clinical factors. Eight hundred three patients undergoing liver resection were divided into 3 groups: young patients (YP), <65 years (n = 387), elderly patients (EP), from 65 to 74 years (n = 279); very-elderly patients (VEP), ≥75 years (n = 137). Severe morbidity was 10.6%, 12.2%, and 17.5% (P = .103), and mortality was 0.3%, 1.4%, and 4.4% (P = .002) in group YP, EP, and VEP, respectively. Ischemic heart disease, cirrhosis, major hepatectomy, biliary tract-associated procedure, and red blood cells (RBC) transfusion ≥3 U were related with severe morbidity. Ischemic heart disease, cirrhosis, major hepatectomy, and RBC transfusion were independent risk factors for postoperative mortality. Age did not result an independent factor related to mortality and severe morbidity. Two different scores were developed and have proved to be statistically related with severe morbidity and mortality. Moreover, in patients with score ≥2, severe morbidity increased from 24.2% in YP, to 29.3% in EP, and to 40.0% in VEP, P = .047. Likewise, mortality increased from 2.3% in YP, to 7.0% in EP, and to 22.7% in VEP, in patients with score ≥2, P = .017. Age alone should not be considered a contraindication for hepatectomy. We identified factors and proposed 2 scores that can be useful to stratify the risk of morbidity and mortality after hepatectomy. Moreover, severe morbidity and mortality increases according to the different age intervals in patients with scores ≥2. Wolters Kluwer Health 2017-05-19 /pmc/articles/PMC5440154/ /pubmed/28514317 http://dx.doi.org/10.1097/MD.0000000000006955 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | 7100 Ruzzenente, Andrea Conci, Simone Ciangherotti, Andrea Campagnaro, Tommaso Valdegamberi, Alessandro Bertuzzo, Francesca Bagante, Fabio Mantovani, Guido De Angelis, Michela Dorna, Adriano E. Piccino, Marco Pedrazzani, Corrado Guglielmi, Alfredo Iacono, Calogero Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
title | Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
title_full | Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
title_fullStr | Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
title_full_unstemmed | Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
title_short | Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
title_sort | impact of age on short-term outcomes of liver surgery: lessons learned in 10-years’ experience in a tertiary referral hepato-pancreato-biliary center |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440154/ https://www.ncbi.nlm.nih.gov/pubmed/28514317 http://dx.doi.org/10.1097/MD.0000000000006955 |
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