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Liver surgeries are high risk surgeries that might result in injuries in kidneys and heart. This study was planned to investigate the frequency of these injuries as well as the risk factors for their devolopment and its effect on patient outcomes.
Hepatic resections are highly invasive major surgical procedures and are associated with higher incidence of end-organ injuries, specifically acute kidney injury (AKI) and perioperative myocardial injury (PMI). This study was designed to determine the incidences of AKI and PMI, and reveal the risk factors for their development and investigate intraoperative labaratory predictors in patients undergoing hepatic resection. We also planned to evaluate the relationship between the occurrence of end-organ injury and length of hospital and intensive care unit (ICU) stay, and 90-day mortality.
Patients were identified from a prospectively maintained data file that involves the perioperative data of patients undergoing surgery at Hepatobiliary-Pancreas clinic of Başakşehir Çam&Sakura City Hospital. All consequtive patients within the study period were evaluated for inclusion. 128 patients were eligible for statistical analysis. This sample size was sufficient to determine the incidence of perioperative organ injury with a margin error of 8.4%. Green formula revealed that the sample size was sufficient for evaluating 9 variables in a regression model.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with organ injury | Patitents who suffered from AKI or PMI | ||
| Patients without organ injury | Patitents who did not suffer from AKI or PMI |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of patients sufferd from Acute Kidney injury | at least 0.3mg/dL or 50% increase from baseline creatinine levels within 3 days postoperatively is described as Acute Kidney İnjury. Data will be presented as frequency(percentage) and the margin error of the percentage | 3 days postoperatively |
| Number of patients suffered from Perioperative myocardial injury | At least 14 ng/L increase from baseline high sensitive Troponin T levels within 3 days psotoperatively is described as perioperative myocardial injury. Data will be presented as frequency(percentage) and the margin error of the percentage | 3 days postoperatively |
| Number of patients suffered from perioperative organ injury | Occurence of acute kidney injury or perioperative myocardial injury within 3 days in patients undergoing hepatic resection. Descriptions are clarified in the prior outcomes' description sections. Data will be presented as frequency(percentage) and the margin error of the percentage | 3 days postoperatively |
| Odds Ratios of Risk Factors for the Occurence of perioperartive organ injury | Patients' demographic, medical and intraoperative characteristics will be evaluated in terms of the occurence of perioperative organ injury. Variables with the p value < 0,05 will be added to the logistic regression model. | 3 days postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Length of intensive care unit stay | Length of intensive care unit stay during postoperative period will be evaluated in patients who did and did not suffer from perioperative organ injury | 90 days postoperatively |
| Length of hospital stay |
| Measure | Description | Time Frame |
|---|---|---|
| Area under the curve of receiver operating characteristics curve generated by using intraoperative Lactate, base excess, venous saturation and delta carbondioxide pressure | intraoperative labaratory parameters obtained by arterai blood gas analysis will be evaluated by creating a model with logistic regression | 3 days postoperatively |
Inclusion Criteria:
Exclusion Criteria:
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patients who underwent resection in Hepatobiliary&Pancreatic Surgery Clinic of Başakşehir Çam&Sakura City Hospital, between june 2021 and june 2024
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Başakşehir Çam&Sakura City Hospital | Istanbul | 34480 | Turkey (Türkiye) |
All raw data that will be used during the statitistical analysis will be shared by the primary investigator upon reosanable request
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| ID | Term |
|---|---|
| D008113 | Liver Neoplasms |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
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Length of hospital stay in the postoperative period, including intensive care will be evaluated in patients who did and did not suffer from perioperative organ injury
| 90 days postoperatively |
| 90-day mortality | 90-day mortality following the surgery will be evaluated in patients who did and did not suffer from perioperative organ injury | 90 days postoperatively |
| D008107 |
| Liver Diseases |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |