Abstract
Objective:Preoperative surgical risk assessment is important in terms of postoperative morbidity and mortality. Therefore, it is necessary to evaluate the efficacy and safety of these surgeries via an ideal risk assessment model, and reduce risks via applying some findings (for instance, perioperative beta-blockers). There are some risk assessment systems, but these have generally not been verified for patients with gynecologic cancer. The aim of this study was to assess the risk of surgery for gynecological oncologic patients and suggest an easy risk assessment model and risk reduction by applying our findings.Materials and Methods:We retrospectively analyzed 258 gynecologic patients with cancer. Age, diagnosis, staging, performance scale, metoprolol use, heart, renal diabetes, Chronic Obstructive Pulmonary disease, diabetes, operation type and length, carcinoma antigen 125, ascites, albumin, surgical procedure, hospitalization length, and complications were recorded.Results:Of the 258 patients, 173 patients (67.1%) had no complications, 43 patients (16.7%) had one and 42 patients (16.3%) had two or more complications. The most common complication was the acid-base imbalance (14%), followed by urinary tract infection (9.7%). Parameters associated with complications were performance status, ascites, operating length, metoprolol use, and upper abdominal surgery. In our proposed scoring model with a total score range 0-23, cut-off value points for both the presence and rate of complications was found as >5.Conclusion:In gynecological patients with cancer, the addition of metoprolol use and upper abdominal surgery within preoperative risk assessment evaluation parameters are significantly effective in predicting the rate and severity of complications. Moreover, we have suggested a simple, practical, and convenient scoring model for this evaluation.
Highlights
In 2016, approximately 105.000 new cases of gynecologic malignancies were estimated in the United States of America[1]
Parameters associated with complications were performance status, ascites, operating length, metoprolol use, and upper abdominal surgery
Main findings Our study demonstrates that preoperative metoprolol use decreases and upper abdominal surgery increases the risk and number of postoperative complications in gynecological
Summary
In 2016, approximately 105.000 new cases of gynecologic malignancies were estimated in the United States of America[1]. An ideal risk assessment model would be simple, reproducible, authentic and correct, objective, and accessible to all patients, and especially able to perform personalized assessments of patients according to the use of patientspecific characteristics[5,8]. Ideally, it should be low-cost and feasible to perform at the bedside[8]. The aim of this study was to assess the risk of surgery for gynecological oncologic patients and to suggest an easy risk assessment model that was feasible to perform at the bedside, and reduce risk of postoperative complications by applying our data and findings
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