Table 3.
Factors associated with return to the operating room (ROR) and a post-pancreatectomy haemorrhage (PPH) > 4 units blood in the first 72 h after surgery
| Clinical characteristic | All patients (n = 13771) |
No ROR with PPH >4 units |
ROR with PPH >4 units |
P | |||
|---|---|---|---|---|---|---|---|
| n or median | % or range | n or median | % or range | n or median | % or range | ||
| n | 13771 | 13682 | 89 | ||||
| Pre-operative factors | |||||||
| Lack of independent function | 380 | 2.8% | 373 | 2.7% | 7 | 7.9% | 0.003 |
| AST > 46 IU/l | 3066 | 25.4% | 3035 | 25.3% | 31 | 39.7% | 0.003 |
| Alkaline phosphatase ≥ 126 IU/l | 4411 | 36.6% | 4376 | 36.6% | 35 | 48.6% | 0.035 |
| Albumin < 3.5 g/dl | 3129 | 26.5% | 3097 | 26.4% | 32 | 42.7% | 0.002 |
| ASA class ≥ 3 | 9161 | 66.5% | 9091 | 66.4% | 70 | 78.7% | 0.015 |
| Disseminated cancer | 495 | 3.6% | 487 | 3.6% | 8 | 9.0% | 0.006 |
| Pre-operative sepsis | 467 | 3.4% | 459 | 3.4% | 8 | 9.0% | 0.003 |
| Bleeding disorder | 382 | 2.8% | 375 | 2.7% | 7 | 7.9% | 0.003 |
| Intra-operative | |||||||
| Operative time, min | 314 | 12–1146 | 313 | 12–1146 | 358 | 81–892 | 0.021 |
| Operative time ≥ 360 min | 5069 | 36.8% | 5026 | 36.7% | 43 | 48.3% | 0.024 |
| Any intra-operative transfusion | 3002 | 28.7% | 2949 | 28.5% | 53 | 59.6% | <0.001 |
| RBC ≥ 4 | 718 | 6.9% | 689 | 6.7% | 29 | 32.6% | <0.001 |
| Concurrent major GI/GU | 990 | 7.2% | 376 | 7.1% | 14 | 15.7% | 0.002 |
| PD/total versus distal pancreatectomy | 0.267 | ||||||
| PD/total | 9140 | 66.4% | 9076 | 66.3% | 64 | 71.9% | |
| Distal | 4631 | 33.6% | 4606 | 33.7% | 25 | 28.1% | |
| Post-operative | |||||||
| Sepsis/septic shock | 1899 | 13.8% | 1858 | 13.6% | 41 | 46.1% | <0.001 |
| Acute renal insufficiency/failure | 238 | 1.7% | 222 | 1.6% | 16 | 18.0% | <0.001 |
| Failure to wean ventilator 48 h | 694 | 5.0% | 649 | 4.7% | 45 | 50.6% | <0.001 |
| Post-operative pneumonia | 706 | 5.1% | 682 | 5.0% | 24 | 27.0% | <0.001 |
| Organ space infection | 1451 | 10.5% | 1431 | 10.5% | 20 | 22.5% | <0.001 |
| Cardiac arrest | 151 | 1.1% | 141 | 1.0% | 10 | 11.2% | <0.001 |
| Post-operative LOS | 8 | 1–215 | 8 | 1–215 | 13 | 1–73 | <0.001 |
| Death within 30 days | 357 | 2.6% | 334 | 2.4% | 23 | 25.8% | <0.001 |
ASA, American Society of Anesthesiologists; AST, aspartate aminotransferase; GI, gastrointestinal; GU, genitourinary; LOS, length of stay; PD, pancreaticoduodenectomy; RBC, (units) red blood cells.
- Not significant: age, gender, race, body mass index, platelets, sodium, blood urea nitrogen, creatinine, partial thrombin time, international normalized ratio, total bilirubin, white blood cells, steroid use; lung disease, dyspnoea, diabetes, previous coronary stent; previous cardiac surgery; medical hypertension, alcohol use, smoking, pre-operative stroke, pre-operative radiation therapy, operation in preceding 30 days, pre-operative chemotherapy, pre-operative weight loss ≥ 10%, dehiscence; superficial or deep surgical site infection, venous thromboembolism.