胃癌根治性胃切除术后安全出院标准。

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Ali Guner, Ki Yoon Kim, Sung Hyun Park, Minah Cho, Yoo Min Kim, Woo Jin Hyung, Hyoung-Il Kim
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引用次数: 4

摘要

目的:本研究旨在探讨临床和实验室参数与并发症状态的关系,以预测哪些患者可以在术后第三天安全出院。材料和方法:从前瞻性维护的数据库中回顾了2110例连续接受根治性手术的胃腺癌患者的数据。收集第三次POD生命体征、实验室数据及术后病程细节。第三次POD后出现II级及以上并发症的患者不适合提前出院。计算了所有算法参数的性能指标。使用来自同一中心的连续患者的验证数据集对该算法进行了测试。结果:1438例患者中,142例(9.9%)被认为不适合提前出院。c反应蛋白水平、体温、脉搏率和中性粒细胞计数具有良好的表现指标,并被确定为独立的预后因素。由这4个参数组成的算法的负预测值(NPV)为95.9%(95%置信区间[CI], 94.2 ~ 97.3),敏感性为80.3% (95% CI, 72.8 ~ 86.5),特异性为51.1% (95% CI, 48.3 ~ 53.8)。研究队列中只有28例(1.9%)患者被归类为假阴性。在验证数据集中,NPV为93.7%,敏感性为66%,3.3%(17/512)的患者被分类为假阴性。结论:第三次POD获得的简单临床和实验室参数可用于决定胃切除术患者的早期安全出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safe Discharge Criteria After Curative Gastrectomy for Gastric Cancer.

Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD).

Materials and methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center.

Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives.

Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.

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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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