Measuring the impact of specific surgical complications after ovarian cancer cytoreductive surgery on short-term outcomes
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View abstract on PubMed
Summary
This summary is machine-generated.Specific peri-operative complications like bowel leaks, venous thromboembolic events, and cardiac events significantly impact patient outcomes and resource use after cytoreductive surgery for advanced ovarian cancer. Addressing these can prevent adverse events.
Area Of Science
- Oncology
- Surgical Oncology
- Health Services Research
Background
- Cytoreductive surgery is a cornerstone treatment for advanced ovarian cancer.
- Peri-operative complications can significantly affect patient outcomes and healthcare resource utilization.
- Quantifying the impact of specific complications is crucial for improving patient care and resource allocation.
Purpose Of The Study
- To measure the impact of specific peri-operative complications following primary cytoreductive surgery on patient outcomes.
- To assess the effect of these complications on healthcare resource utilization.
- To identify the proportion of adverse outcomes attributable to specific complications.
Main Methods
- A cohort of 892 patients with advanced ovarian cancer undergoing primary cytoreductive surgery (2006-2016) was analyzed.
- Specific complications (bowel leak, surgical site infections, venous thromboembolic events, cardiac events) within 30 days were evaluated.
- Population attributable risk (PAR) and adjusted PAR (aPAR) were calculated to quantify the impact on outcomes like prolonged stay, readmission, reoperation, organ failure, chemotherapy delay, and mortality.
Main Results
- Bowel leak was a major contributor to reoperation (aPAR=45.5%), organ failure (aPAR=13.6%), readmission/non-home discharge (aPAR=5.3%), chemotherapy delay (aPAR=5.9%), and prolonged length of stay (aPAR=13.0%).
- Venous thromboembolic events were associated with 90-day mortality (aPAR=8.6%) and organ failure (aPAR=13.9%).
- Cardiac events were strongly associated with organ failure (aPAR=19.0%). All evaluated complications impacted readmission/non-home discharge.
Conclusions
- Less frequent complications, such as venous thromboembolic events, cardiac events, and bowel leaks, have a substantial impact on patients and resource use.
- Measuring the genuine impact of complications, beyond common scales, provides vital information for providers, patients, and payers.
- Targeting interventions to reduce these specific complications can improve outcomes and resource efficiency in advanced ovarian cancer surgery.
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