Hu Yanjie, Zeng Siyu, Li Lele, Fang Yuanchen, He Xiaozhou
West China School of Nursing, West China Hospital, Sichuan University, No. 37#, Guoxue Road, Chengdu, China.
Business School, Sichuan University, No. 24 South Section 1, Yihuan Road, Chengdu, China.
Cost Eff Resour Alloc. 2021 Oct 2;19(1):64. doi: 10.1186/s12962-021-00318-z.
Postoperative complications increase the workload of nursing staff as well as the financial and mental distress suffered by patients. The objective of this study is to identify clinical factors associated with postoperative complications after liver cancer resection surgery.
Data from liver cancer resections occurring between January 1st, 2019 to December 31st, 2019 was collected from the Department of Liver Surgery in West China Hospital of Sichuan University. The Kruskal-Wallis test and logistic regression were used to perform single-factor analysis. Stepwise logistic regression was used for multivariate analysis. Models were established using R 4.0.2 software.
Based on data collected from 593 cases, the single-factor analysis determined that there were statistically significant differences in BMI, incision type, incision length, duration, incision range, and bleeding between cases that experienced complications within 30 days after surgery and those did not. Stepwise logistic regression models based on Kruskal-Wallis test and single-factor logistic regression determined that BMI, incision length, and duration were the primary factors causing complications after liver resection. The adjust OR of overweight patients and patients with obesity (stage 1) compared to low weight patients were 0.12 (95% CI:0.02-0.72) with p = 0.043 and 0.18 (95% CI:0.03-1.00) with p = 0.04, respectively. An increase of 1 cm in incision length increased the relative risk by 13%, while an increase of 10 min in surgical duration increased the relative risk by 15%.
The risk of postoperative complications after liver resection can be significantly reduced by controlling factors such as bleeding, incision length, and duration of the surgery.
术后并发症增加了护理人员的工作量以及患者的经济和精神负担。本研究的目的是确定与肝癌切除术后并发症相关的临床因素。
收集四川大学华西医院肝脏外科2019年1月1日至2019年12月31日期间肝癌切除术的数据。采用Kruskal-Wallis检验和逻辑回归进行单因素分析。采用逐步逻辑回归进行多因素分析。使用R 4.0.2软件建立模型。
基于593例患者的数据，单因素分析确定，术后30天内出现并发症的患者与未出现并发症的患者在体重指数、切口类型、切口长度、手术时长、切口范围和出血量方面存在统计学显著差异。基于Kruskal-Wallis检验和单因素逻辑回归的逐步逻辑回归模型确定，体重指数、切口长度和手术时长是肝切除术后导致并发症的主要因素。超重患者和肥胖（1期）患者与低体重患者相比，调整后的比值比分别为0.12（95%CI：0.02-0.72），p = 0.043和0.18（95%CI：0.03-1.00），p = 0.04。切口长度每增加1厘米，相对风险增加13%，而手术时长每增加10分钟，相对风险增加15%。
通过控制出血、切口长度和手术时长等因素，可显著降低肝切除术后并发症的风险。
