单中心胃癌围手术期死亡因素分析

Risk factors for post-gastrectomy mortality in patients with gastric cancer: a single center experience

回顾诊断为胃癌并行手术治疗后于住院期间或手术后<30 d死亡患者36例,同时随机调取胃癌手术后恢复良好并顺利出院且术后生存时间≥30 d的患者共230例,采用二分类非条件Logistic回归分析围手术期死亡主要影响因素。结果显示胃癌围手术期死亡率为0.50%(36/7 133)。多因素Logistic回归分析提示年龄、ASA评分、合并呼吸系统疾病及肿瘤分期是导致胃癌围手术期死亡的危险因素。高龄晚期胃癌伴有合并疾病患者围手术期死亡率较高,应完善术前准备,进行术前干预,降低胃癌围手术期死亡率。

The clinical date of 36 cases of the total gastric cancer patients who received surgical treatment died within 30 days or during the initial hospital stay were retrospectively studied. These patients were compared with a randomly-chosen 230 patients who underwent the same operation during the same interval, and were alive after 30 days and discharged from hospital. The risk factors influencing postoperative mortality were determined by binary non-conditional logistic regression analysis. The mortality rate after surgical treatment was 0. 50% （36/7 133）. Multivariate regression analysis identified that the advanced age, ASA score, pulmonary comorbidities, and tumor stage were correlated with the postoperative mortality. The elderly patients with advanced gastric cancer and comor-bid diseases have a high risk of postoperative mortality. To strengthen the preoperative preparation and intervention to reduce postoperative mortality of gastric cancer is a pressing task.