ABSTRACT
INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥70 years (OR = 1.85, 95% CI: 1.25-2.76), ASA III-IV (OR = 2.06, 95% CI: 1.28-3.34), total gastrectomy (OR = 1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR = 5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age ≥70 years (OR = 4.92, 95% CI:1.78-13.65), lower BMI (OR = 0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR = 0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age ≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age ≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.
Subject(s)
Hypoalbuminemia , Stomach Neoplasms , Aged , Gastrectomy/adverse effects , Humans , Hypoalbuminemia/complications , Hypoalbuminemia/epidemiology , Morbidity , Retrospective Studies , Risk Factors , Stomach Neoplasms/etiology , Stomach Neoplasms/surgeryABSTRACT
INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥ 70 years (OR=1.85, 95% CI: 1.25-2.76), ASA III-IV (OR=2.06, 95% CI: 1.28-3.34), total gastrectomy (OR=1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR=5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age≥70 years (OR=4.92, 95% CI:1.78-13.65), lower BMI (OR=0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR=0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.
ABSTRACT
BACKGROUND: Acute otitis media (AOM) is a serious public health problem and is considered one of the most common diagnoses in pediatric outpatient units. The aim of this study was to asses the incidence and distribution of AOM by age, sex, number of visits per episode, and the most frequent symptoms and signs in four pediatric primary care units. PATIENTS AND METHODS: A 12-month (1 September 2000 to 31 August 2001), prospective study was carried out in a primary care center on the outskirts of Madrid. RESULTS: During the study period there were 1,098 consultations for AOM in 521 patients. The overall incidence per 100,000 children aged less than 14 years was 12,080 cases (95 % CI: 11,120-13,090). The highest incidence per 100,000 children was in children aged 12-23 months with 38,780 cases (95 % CI: 33,340-44,430). A total of 34.5 % of the children diagnosed with AOM were aged less than 2 years. Ninety-six percent of the children received antibiotics. Most (81.4 %) of the children were completely cured while symptoms persisted in 15.4 %. A minority of the children (3.5 %) were referred to the otolaryngology department.
Subject(s)
Otitis Media , Acute Disease , Age Distribution , Child , Child, Preschool , Female , Humans , Incidence , Infant , Male , Otitis Media/diagnosis , Otitis Media/drug therapy , Otitis Media/epidemiology , Primary Health Care , Prospective StudiesABSTRACT
Antecedentes: La otitis media aguda (OMA) supone un importante problema de salud pública debido a su alta frecuencia, y se considera un diagnóstico muy frecuente en las consultas de Pediatría. Nuestro objetivo fue conocer la incidencia de OMA atendidas en cuatro consultas de Pediatría, así como conocer su distribución por edad y sexo, número de visitas realizadas por episodio, y síntomas y signos otoscópicos más frecuentes. Pacientes y métodos: Se trata de un estudio de casos clínicos prospectivos realizado en un Centro de Salud periurbano de Madrid durante un período de 12 meses (septiembre 2000-agosto 2001). Resultados: Durante el período de estudio se atendieron 1.098 visitas motivadas por OMA en 521 pacientes. La incidencia total fue de 12.080 casos por cada 100.000 menores de 14 años (intervalo de confianza del 95 por ciento [IC 95 por ciento], 11.120-13.090). Con una incidencia máxima entre los 12 y los 23 meses de edad con 38.780 casos por cada 100.000 niños (IC 95 por ciento, 33.340-44.430). Un 34,5 por ciento de los niños diagnosticados de OMA eran menores de 2 años de edad. El 96 por ciento de los pacientes recibieron tratamiento antibiótico. El 81,4 por ciento de los niños presentaron una curación completa, mientras que en el 15,4 por ciento de los casos se observó persistencia de la sintomatología. El 3,5 por ciento de los niños fueron derivados al otorrinolaringólogo (AU)
