Key result
In women undergoing cytoreductive surgery for ovarian cancer, higher surgical complexity scores were significantly associated with an increased risk of postoperative pulmonary complications (OR 1.26).
Why the study?
The prevalence of postoperative pulmonary complications (PPCs), associated perioperative factors, and their link to outcomes after cytoreductive surgery for ovarian cancer required evaluation.
What are the risk factors for postoperative pulmonary complications and their impact on outcomes in ovarian cancer patients undergoing cytoreductive surgery?
Cohort (n=268)
No
What are the risk factors for postoperative pulmonary complications and their impact on outcomes in ovarian cancer patients undergoing cytoreductive surgery?
In ovarian cancer patients undergoing cytoreductive surgery, higher surgical complexity, diaphragmatic resection, and increased intraoperative fluid infusion are associated with postoperative pulmonary complications, which significantly increase the risk of 30-day readmission.
Answers are grounded in this paper and cite their sources.
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PPCs may flag elevated readmission risk after ovarian cytoreductive surgery; leaves open whether prevention strategies improve outcomes in prospective trials.
OBJECTIVES: To assess the prevalence of postoperative pulmonary complications (PPCs), the perioperative factors associated with PPCs, and the association of PPCs with postoperative outcomes in ovarian cancer patients undergoing cytoreductive surgery. METHODS: A retrospective analysis was conducted on patients who underwent cytoreductive surgery in our hospital, between September 2017 and January 2021, and patient medical records were reviewed to collect relevant clinical information. Univariable and multivariable analyses were used to identify significant risk factors for PPCs. Analysis of the association of PPCs with postoperative outcomes, mortality and 30-day readmission, was undertaken utilizing propensity score-matched controls and multivariable logistic regression model. RESULTS: Final analysis was performed with 268 ovarian cancer patients after cytoreductive surgery, among whom the incidence of PPCs was 26.9%, and the most frequent pulmonary complication was pleural effusion. According to the multivariate analysis, the intraoperative fluid infusion volume (L) (odds ratio (OR) 1.34; 95% confidence intervals (CI) 1.01-1.77; P = 0.040), diameter size of diaphragmatic resection (cm) (OR 1.16; 95% CI 1.06-1.28; P = 0.002), and surgical complexity scores (OR 1.26; 95% CI 1.13-1.42; P < 0.001) were significantly associated with the development of PPCs. The multivariable logistic regression analyses with propensity-matched controls demonstrated that the occurrence of PPCs significantly increased the risk of 30-day readmission (OR 6.01; 95% CI 1.12-32.40; P = 0.037) and did not significantly affect inpatient mortality. CONCLUSION: Ovarian cancer patients undergoing cytoreductive surgery, especially those with diaphragmatic resection or higher surgical complexity scores, represent a high-risk population for PPCs. In addition, goal-directed fluid therapy is vital to reducing the occurrence of PPCs in patients at risk. PPCs were not associated with in-hospital mortality but were significantly associated with an increased risk of 30-day readmission after cytoreductive surgery.
Xu et al. (2022) conducted a cohort in Ovarian Cancer (n=268). Higher surgical complexity score vs. Lower surgical complexity score was evaluated on Postoperative pulmonary complications (PPCs) within 30 days (OR 1.26, 95% CI 1.13-1.42, p=<0.001). In women undergoing cytoreductive surgery for ovarian cancer, higher surgical complexity scores were significantly associated with an increased risk of postoperative pulmonary complications (OR 1.26).