Morbidity related to concomitant adhesions in abdominal surgery

Abstract Background We sought to assess the independent effect of concomitant adhesions (CAs) on patient outcome in abdominal surgery. Materials and methods Using the American College of Surgeons National Surgical Quality Improvement Program data, we created a uniform data set of all gastrectomies,...

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Bibliographic Details
Published in:The Journal of surgical research 2014-12, Vol.192 (2), p.286-292
Main Authors: Mavros, Michael N., MD, Velmahos, George C., MD, PhD, Lee, Jarone, MD, MPH, Larentzakis, Andreas, MD, PhD, Kaafarani, Haytham M.A., MD, MPH
Format: Article
Language:English
Subjects:
Abdomen - pathology
Abdomen - surgery
Adhesiolysis
Adhesions
Aged
Benchmarking
Comorbidity
Digestive System Surgical Procedures - adverse effects
Digestive System Surgical Procedures - standards
Female
Gastrectomy - adverse effects
Gastrectomy - standards
General surgery
Hepatectomy - adverse effects
Hepatectomy - standards
Humans
Logistic Models
Male
Middle Aged
Morbidity
Multivariate Analysis
Pancreatectomy - adverse effects
Pancreatectomy - standards
Peritoneum - pathology
Peritoneum - surgery
Postoperative complications
Quality Improvement
Risk Adjustment
Risk Factors
Surgery
Tissue Adhesions - epidemiology
Tissue Adhesions - pathology
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Summary:Abstract Background We sought to assess the independent effect of concomitant adhesions (CAs) on patient outcome in abdominal surgery. Materials and methods Using the American College of Surgeons National Surgical Quality Improvement Program data, we created a uniform data set of all gastrectomies, enterectomies, hepatectomies, and pancreatectomies performed between 2007 and 2012 at our tertiary academic center. American College of Surgeons National Surgical Quality Improvement Program data were supplemented with additional variables (e.g., procedure complexity–relative value unit). The presence of CAs was detected using the Current Procedural Terminology codes for adhesiolysis (44005, 44180, 50715, 58660, and 58740). Cases where adhesiolysis was the primary procedure (e.g., bowel obstruction) were excluded. Multivariable logistic regression analyses were performed to assess the independent effect of CAs on 30-d morbidity and mortality, while controlling for age, comorbidities and the type/complexity/approach/emergency nature of surgery. Results Adhesiolysis was performed in 875 of 5940 operations (14.7%). Operations with CAs were longer (median duration 3.2 versus 2.7 h, P  
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2014.07.044