Postoperative sepsis prediction in patients undergoing major cancer surgery

Abstract Background Cancer patients are at increased risk for postoperative sepsis. However, studies addressing the issue are lacking. We sought to identify preoperative and intraoperative predictors of 30-d sepsis after major cancer surgery (MCS) and derive a postoperative sepsis risk stratificatio...

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Bibliographic Details
Published in:The Journal of surgical research 2017-03, Vol.209, p.60-69
Main Authors: Sood, Akshay, MD, Abdollah, Firas, MD, Sammon, Jesse D., DO, Arora, Nivedita, MD, Weeks, Matthew, BS, Peabody, James O., MD, Menon, Mani, MD, Trinh, Quoc-Dien, MD
Format: Article
Language:English
Subjects:
Aged
Cancer
Female
Humans
Male
Middle Aged
Neoplasms - surgery
Perioperative mortality
Postoperative Complications - epidemiology
Quality Improvement
Risk Assessment
Sepsis
Sepsis - epidemiology
Septic shock
Surgery
United States - epidemiology
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Summary:Abstract Background Cancer patients are at increased risk for postoperative sepsis. However, studies addressing the issue are lacking. We sought to identify preoperative and intraoperative predictors of 30-d sepsis after major cancer surgery (MCS) and derive a postoperative sepsis risk stratification tool. Methods Patients undergoing one of nine MCSs (gastrointestinal, urological, gynecologic, or pulmonary) were identified within the American College of Surgeons National Surgical Quality Improvement Program (2005-2011, n  = 69,169). Multivariable adjusted analyses (MVA) were performed to identify the predictors of postoperative sepsis. A composite sepsis risk score (CSRS) was constructed using the regression coefficients of predictors significant on MVA. The score was stratified into low, intermediate, and high risk, and its predictive accuracy for sepsis, septic shock, and mortality was assessed using the area under the curve analysis. Results Overall, 4.3% ( n  = 2954) of patients developed postoperative sepsis. In MVA, Black race (odds ratio [OR] = 1.30, P  = 0.002), preoperative hematocrit
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2016.09.059