Background
Methods
Medical outcome survey Short-Form 36 (SF-36)
Activities of Daily Living (ADL)
Outcome
Statistical methods
Results
Variable | All | Malignant | Benign | P |
---|---|---|---|---|
(n =70) | (n = 58) | (n = 12) | ||
Age in years,
median
(IQR)
|
59
(48–67)
|
61
(52–69)
|
43
(35–52)
|
<0.001
c
|
Age group, n (%) | 0.002b
| |||
<65 years | 42 (60) | 30 (52) | 12 (100) | |
65 years | 28 (40) | 28 (48) | 0 (0) | |
Sex,
n
(%)
|
0.
011
a
| |||
Male | 35 (50) | 33 (57) | 2 (17) | |
Female | 35 (50) | 25 (43) | 10 (83) | |
ASA physical status,
n (%)
|
<0.
001
a
| |||
I/II | 23 (33) | 11 (19) | 12 (100) | |
III/IV | 47 (67) | 47 (81) | 0 (0) | |
Body Mass Index in Kg/m2, median (IQR) | 25 (22–30) | 26 (23–30) | 22 (21–30) | 0.163b
|
Type of anesthesia, n (%) | 0.440a
| |||
General | 59 (84) | 48 (83) | 11 (92) | |
Combined general locorregional | 11 (16) | 10 (17) | 1(8) | |
Duration of anesthesia (minutes), median (IQR) | 300 (268–360) | 300 (270–360) | 285 (245–315) | 0.298b
|
Intraoperative fluid volume | ||||
Crystalloids (L.), median (P25–P75) | 4.0 (3.2 – 4.9) | 4.0 (3.3 – 4.9) | 3.0 (3.0 – 5.2) | 0.174b
|
Colloids (L.), median (P25–P75) | 0.5 (0 – 0.5) | 0.5 (0 – 0.5) | 0 (0 – 0.4) | 0.083b
|
Erythrocytes (Unit), median (P25–P75) | 0 (0 – 1.0) | 0 (0 – 1.0) | 0 (0 – 0.0) | 0.163b
|
Fresh Frozen plasma (Unit), median (P25–P75) | 0 (0–0) | 0 (0–0) | 0 (0–0) | 0.295b
|
Platelets (Unit), median (P25–P75) | 0 (0–0) | 0 (0–0) | 0 (0–0) | 0.517b
|
Temperature at PACU admission (°C), median (IQR) | 34.7 (33.9–35.5) | 34.8 (33.9–35.6) | 34.7 (33.5–35.2) | 0.623b
|
Hypertension,
n (%)
|
37
(53)
|
35
(60)
|
2
(17)
|
0.
006
a
|
Hyperlipidemia,
n (%)
|
25
(36)
|
24
(41)
|
1
(8)
|
0.
030
a
|
Pulmonary obstructive disease, n (%) | 8 (11) | 8 (14) | 0 (0) | 0.172a
|
Ischemic heart disease, n (%) | 6 (9) | 6 (10) | 0 (0) | 0.244a
|
Congestive heart disease, n (%) | 10 (14) | 10 (17) | 0 (0) | 0.132a
|
Cerebrovascular disease, n (%) | 3 (4) | 3 (5) | 0 (0) | 0.778a
|
Renal insufficiency, n (%) | 4 (6) | 3(5) | 1 (8) | 0.668a
|
Insulin therapy for diabetes, n (%) | 3 (4) | 3(5) | 0 (0) | 0.421a
|
Total RCRI, n (%) | 0.349a
| |||
≤2 | 66 (94) | 54 (93) | 12 (100) | |
>2 | 4 (6) | 4 (7) | 0 (0) | |
Katz scale, median (IQR) | 0 (0–0) | 0 (0–0) | 0 (0–0) | 0.424b
|
Dependency in I-ADL, n (%) | 3 (4) | 3 (5) | 0 (0) | 0.421a
|
Lawton I-ADL, median (IQR) | 7 (7–7) | 7 (7–7) | 7 (7–7) | 0.176b
|
Dependency in P-ADL, n (%) | 7 (10) | 7 (12) | 0 (0) | 0.205a
|
SAPS II,
median (P25–75)
|
24
(15–37)
|
29
(21–39)
|
7
(0–13)
|
<0.
001
b
|
APACHE II, median (IQR)
|
7
(5–11)
|
8
(6–11)
|
4
(3–6)
|
<0.
001
b
|
AKI | 7 (10) | 6 (10) | 1(8) | 0.833a
|
Delirium
|
17
(24)
|
17
(29)
|
0
(0)
|
0.
025
a
|
PACU length of stay (minutes), median (IQR) | 21 (19–57) | 21 (19–57) | 31 (20–60) | 0.501a
|
Hospital length of stay (days), median
(IQR)
|
10
(7–15)
|
11
(7–16)
|
8
(7–11)
|
0.
034
b
|
Mortality in PACU, n (%) | 3(4) | 3 (5) | 0 (0) | 0.421a
|
Mortality in hospital, n (%) | 5 (7) | 5 (9) | 0 (0) | 0.291a
|
Mortality at 6 months follow-
up
|
13
(19)
|
13
(22)
|
0
(0)
|
0.
011
a
|
Variable | Nonsurvivors/survivors | OR (95% CI) | P (a) |
---|---|---|---|
n (%) or median (IQR) | n = 13 n = 57 | ||
Type of hepatectomy surgery | 0.105 (b) | ||
for malignant disease | 13 (100) / 45 (78) | – | |
for benign disease | 0 (0) /12 (21) | 1 | |
Age | 65 (54 – 71) / 57 (44 – 66) | 1.04 (0.99 – 1.10) | 0.109 |
Gender | 0.759 | ||
Female | 6 (46) / 29 (51) | 1 | |
Male | 7 (54) / 28 (49) | 0.83 (0.25 – 2.77) | |
BMI, median | 25 (22 – 31) /25 (22 – 29) | 0.99 (0.88 – 1.13) | 0.981 |
Type of anesthesia | 0.424 | ||
General | 10 (77) /49 (86) | 1 | |
Combined general loco regional | 3 (23) / 8 (14) | 1.84 (0.41 – 8.16) | |
Duration of anesthesia (minutes) | 300 (255 – 395) / 300 (265–330) | 1.01 (0.99 – 1.01) | 0.161 |
ASA Physical status | 0.443 (b) | ||
I/II | 0 (0) /23 (40) | 1 | |
III/IV | 13 (100) / 34 (60) | – | |
Intraoperative fluid volume, median | |||
Crystalloids (L.) | 4.2 (4.0– 5.0) / 4.0 (3.1 – 4.9) | 1.26 (0.86 – 1.87) | 0.239 |
Colloids (L.) | 0.5 (0–1.0) / 0.5 (0 – 0.5) | 1.39 (0.34 – 5.79) | 0.649 |
Erythrocytes
(Unit)
|
1
(0 –
3.
0) /
0
(0
–
1)
|
2.
92
(1.
25
–
6.
81)
|
0.
013
|
Fresh Frozen plasma (Unit) | 0 (0 – 0) / 0 (0 – 0) | 1.44 (0.80 – 2.58) | 0.221 |
Platelets (Unit) | 0 (0 – 0) / 0 (0 – 0) | – | 1 |
Temperature at admission | 34.2 (33.3 – 35.1) / 35.0 (33.9 – 35.6) | 0.72 (0.44 – 1.17) | 0.184 |
Hypertension | 8 (62) / 29 (51) | 1.55 (0.45 – 5.30) | 0.489 |
Hyperlipidaemia | 7 (54) / 18 (32) | 2.53 (0.74 – 8.61) | 0.138 |
Pulmonary obstructive disease | 2 (15) / 6 (11) | 1.55 (0.28 – 8.70) | 0.621 |
Ischemic heart disease | 3 (23) / 3 (5) | 5.40 (0.95 – 30.7) | 0.057 |
Congestive heart disease | 3 (23) / 7 (12) | 2.14 (0.47 – 9.73) | 0.324 |
Cerebrovascular disease | 2 (15) /1 (2) | 10.18 (0.85 – 122) | 0.067 |
Insulin therapy for diabetes | 2 (15) / 1 (2) | 10.18 (0.85 – 122) | 0.067 |
Renal insufficiency | 1 (8) / 3 (5) | 1.50 (0.14 – 15.7) | 0.735 |
RCRI
|
0.019
| ||
≤2
|
10
(77)
/
56
(
98
)
|
1
| |
>2
|
3
(
23
) /
1
(
2
)
|
16
.
8
(
1
.
59
–
178
)
| |
Delirium
|
9 (69 ) / 8 ( 14 )
|
13
.
78
(
3
.
42
–
55
.
60
)
|
<
0
.
001
|
Previous score in Katz scale | 0 (0 – 0) / 0 (0 – 0) | – | 1 |
Previous score in Lawton scale | 7 (7 – 7) / 7 (7 – 7) | – | 1 |
SAPS II,
median
|
32
.
0
(
23
.
5
–
48
.
0
) /
24
.
0
(
13.
0
–
33
.
5
)
|
1.
07
(
1.
02
–
1
.
12
)
|
0
.
011
|
APACHE II
|
12 . 0 ( 10. 5 – 16. 0 ) / 7. 0 (4. 0 – 9. 0)
|
1.
55
(
1.
21
–
1.
98)
|
<0.
001
|
Length of PACU stay (hours) | 20 (18 – 80) / 21 (19 – 50) | 1.01 (0.99 – 1.03) | 0.276 |
Length of Hospital stay (days) | 14 (7 – 17) / 10 (7 – 13) | 1.00 (0.95 – 1.06) | 0.906 |
Mortality
Variable
|
Simple OR
(95%
CI)
|
p
|
Adjusted*
OR
(95%
CI)
|
P
a
|
---|---|---|---|---|
Age | 1.04 (0.99 – 1.10) | 0.109 | 0.97 (0.89 – 1.05) | 0.438 |
Length of PACU stay (minutes) | 1.01 (0.99 – 1.03) | 0.276 | 0.98 (0.95 – 1.01) | 0.263 |
Erythrocytes (Unit) | 2.92 (1.25 – 6.81) | 0.013 | 3.06 (0.95 – 9.84) | 0.061 |
RCRI | 0.019 | 0.152 | ||
≤2 | 1 | 1 | ||
>2 | 16.8 (1.59 – 178) | 6.52 (0.50 – 84.45) | ||
Delirium
|
13.
78
(3.
42
–
55.
60)
|
<0.
001
|
9. 33 (1. 35 – 64. 61)
|
0.
024
|
SAPS II | 1.07 (1.02 – 1.12) | 0.011 | 1.06 (0.98 – 1.15) | 0.169 |
Functional capacity and ADL
Variable | Before surgery | 6 months after surgery | P |
---|---|---|---|
Median (IQR) | Median (IQR) | ||
(n = 44) | (n = 44) | ||
Personal activities of daily living | |||
Katz scale | 0 (0–0) | 0 (0–0) | 0.133 |
Dependency in P-ADL, n (%) | 2 (5) | 5 (11) | 0.323 |
Instrumental activities of daily living | |||
Lawton scale | 7.0 (7.0–7.0) | 7.0 (5.0–7.0) | 0.058 |
Dependency in I-ADL, n (%)
|
3
(7)
|
14
(32)
|
0.
027
|
Quality of life measures
Variable | Before hepatectomy | After hepatectomy | P (a) |
---|---|---|---|
(n = 44) | (n = 44) | ||
SF
-
36 domains
|
mean
±
sd
|
mean
±
sd
| |
Physical function
|
85
.
0
±
20
.
1
|
71
.
4
±
30
.
2
|
0
.
025
|
Role physical | 58.2 ± 35.6 | 63.4 ± 31.9 | 0.406 |
Bodily pain | 67.5 ± 28.1 | 73.8 ± 30.6 | 0.326 |
General health perception | 60.3 ± 21.1 | 60.5 ± 22.6 | 0.979 |
Vitality | 43.4 ± 14.9 | 45.6 ± 14.7 | 0.472 |
Social functioning | 72.4 ± 24.5 | 65.9 ± 28.1 | 0.286 |
Role emotional | 68.6 ± 25.6 | 64.6 ± 30.7 | 0.463 |
Mental health | 52.8 ± 19.4 | 59.1 ± 20.5 | 0.182 |