The reason of operative death and operative risk factors in patients with esophageal cancer after esophagectomy by logistic regression model
- VernacularTitle:食管癌切除术后死亡原因及危险因素的多因素logistic回归分析
- Author:
Bin FENG
;
Yaoguang JIANG
;
Shizhi FAN
;
Ruwen WUANG
;
Qing ZENG
- Publication Type:Journal Article
- From:Journal of Third Military Medical University
2001;23(5):526-529
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors and causes affecting the operative mortality in esophagectomy patients with esophageal can cer. Methods 1400 cases with a curative esophagectomy for neopl asm of esophagus hospitalized from Mar,1973 to June, 2000 were reviewed. There w ere 31 died within 30 d or during hospitalization after esophagectomy as a group , and 1 369 survival cases, after operation, as another group. Sixteen factors t hat may influence the operational mortality were selected. A multi-variate anal ysis of these individual variables was performed by the computer′s logistic reg ression model. Results The operative mortality was 2.2%(31/1400 ). The causes of death included respiratory complication 17 cases (including res piratory failure caused by pneumonia or atelectasis), 15 cases, and adult respir atory distress syndrome (ARDS) 2 cases, the mortality was 54.8% in the death gro up), anastomotic leak 11 cases (34.5%), Chylothorax 2 cases (6.5%) and postopera tive digestive tract hemorrhage 1 case (3.2%). The results showed that the major risk factors that affected operative mortality in cases with esophageal cancer were history of long-herm heavy smoking, duration of operation and the year of operational (P<0.05). Conclusion To minimize operative mort ality of esophagectomy, some means must be noticed, including the reinforcemen t of the perioperative care, the improvement of anastomotic methods and surgical skill, reduing operative time as p ossible, disposing pulmonary complications in time and using respirator if neces sary.
