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Abstracts and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Evidence-based Practice and Quality Improvement

Outcome and quality of life after hepatectomy

1AP1-6

Veiga, D. M.; Luís, C.; Parente, D.; Fernandes, V.; Botelho, M.; Abelha, F. J.

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European Journal of Anaesthesiology: June 2011 - Volume 28 - Issue - p 8
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Background and Goal of Study: Hepatectomy is commonly performed in malignant or benign hepatic diseases and for living donor. Most studies are limited to study mortality and morbidity rates, costs and length of hospital stay (LOS). The aim of the present study was to evaluate outcome and quality of life after hepatectomy and to study its determinants.

Materials and Methods: This prospective study was carried in a Post-Anaesthesia Care Unit (PACU) during a period of 10 months. Thirty five patients were submitted to hepatectomy and were enrolled in this study. Demographic and peri-operative characteristics were evaluated for associations with mortality. At admission and six months after discharge, patients were contacted to complete a Short Form-36 questionnaire (SF-36) and to have their dependency in Activities of Daily Living (ADL) evaluated using Katz and Lawton scales. Patient's characteristics and postoperative follow-up data were compared using Mann-Whitney U test and Fisher's exact test. Patient preoperative characteristics were evaluated for associations with mortality using bynary and multiple logistic regression analyses.

Results and Discussion: The mortality rate was 5% at six months. Univariate analysis identified intra-operative amount of erythrocytes administrated, dyslipidemia and Revised Cardiac Index (RCRI) as determinants for mortality. The multiple logistic regression analyses identified the amount of erythrocytes administrated as an independent risk determinant for mortality at six months. At admission 42% considered that their health in general was worse than one year before and six months after discharge 8% stated the same opinion. Six months after PACU discharge patients had lower SF-36 scores for physical function comparing with admission scores. At this time patients were more dependent in instrumental ADL (26% were dependent in at least one activity versus 0% before surgery, p=0.022).

Conclusion(s): This study identified intra-operative amount of erythrocytes administrated, dyslipidemia and RCRI as risk factors for mortality 6 months after hepatectomy. Survivors who have undergone hepatectomy perceive an improved quality of life although they are more dependent in instrumental ADL tasks and have worse scores in the physical function of the SF-36.

References:

Acta Med Port 2006, 19(4):281-287.19; J Am Geriatr Soc 1983 31(12):721-727.; Intensive Care Med 2005, 31(5):611-620
    © 2011 European Society of Anaesthesiology