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. 2012 Oct;14(10):684-7.
doi: 10.1111/j.1477-2574.2012.00518.x. Epub 2012 Jul 19.

Risk factors associated with delayed haemorrhage after pancreatic resection

Osamu Nakahara  1 , Hiroshi Takamori, Osamu Ikeda, Hideyuki Kuroki, Yoshiaki Ikuta, Akira Chikamoto, Toru Beppu, Yasuyuki Yamashita, Hideo Baba
Affiliations

Risk factors associated with delayed haemorrhage after pancreatic resection

Osamu Nakahara et al. HPB (Oxford). 2012 Oct.

Abstract

Background: Delayed haemorrhage (DH) is a life-threatening complication of pancreatic resection (PR) and the mortality rate for DH is very high. However, the risk factors and prognostic factors associated with DH are rarely evaluated.

Methods: A pancreatic resection was performed on 457 patients. Delayed haemorrhage was defined as bleeding from the surgical site ≥ 5 days after PR. Risk factors for DH were assessed according to demographics and pathological and operative parameters. Prognostic factors after DH were evaluated for the shock index (heart rate/systolic blood pressure) and systemic inflammatory response syndrome (SIRS) scores.

Results: Of the 457 patients, 11 (2.4%) experienced DH after PR. Logistic regression analysis showed that age >60 years and a diagnosis of malignant disease were risk factors for DH. The shock index and SIRS scores at the onset of DH were significantly higher in patients who died as compared with those patients that survived (P < 0.05).

Discussion: PR-associated DH carries an increased risk for patients aged >60 years with malignant disease. Prognostic factors were a shock index score ≥ 0.7 and SIRS at the onset of DH.

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Figures

Figure 1
Figure 1
Correlation of the shock index score between recovered and expired patients. The shock index score was significantly lower in recovered patients than in expired patients (P= 0.001)
Figure 2
Figure 2
Correlation of systemic inflammatory response syndrome (SIRS) score between recovered and expired patients. The SIRS score was significantly lower in recovered patients than in expired patients (P= 0.001). All expired patients experienced SIRS at the onset of delayed haemorrhage
See this image and copyright information in PMC

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