Effect of regional block technique on postoperative high-grade complications according to Clavien-Dindo classification in elderly patients with thoracic and abdominal cancer: a retrospective propensity score matching analysis
- PMID: 38205136
- PMCID: PMC10777742
- DOI: 10.3389/fonc.2023.1305329
Effect of regional block technique on postoperative high-grade complications according to Clavien-Dindo classification in elderly patients with thoracic and abdominal cancer: a retrospective propensity score matching analysis
Abstract
Background: Postoperative complications have an influence on postoperative rehabilitation, length of hospital stay and hospitalization expenses in elderly patients, especially those with higher Clavien-Dindo (C-D) classification. Patients with cancers often experience more serious postoperative complications after surgery. Different anesthesia methods can affect the postoperative outcomes of cancer patients. Regional block techniques have been recommended in guidelines for enhanced recovery after surgery. However, the relationship between regional blocks and high-grade postoperative complications remains unclear, thus, the study explored the relationship between regional block techniques and high-grade postoperative complications graded by C-D classification in elderly patients with thoracic and abdominal cancer.
Method: Retrospective enrollment of eligible elderly patients admitted to Peking University People's Hospital between January 2018 and March 2022 was conducted. Propensity score matching (PSM) and univariate and multivariate regression analyses were used to analyze the potential benefits of regional blocks for elderly patients in real world practice.
Results: A total of 2769 patients were enrolled in this study, including 568 who underwent colorectal resection, 2201 who underwent video-assisted thoracoscopic pneumonectomy. Among them, 2033 patients received regional block, while 736 patients did not. Statistical analysis indicated that regional blocks could reduce the incidence of postoperative complications of C-D classification Grade II or higher, with an Odds ratio (OR) of 0.742, 95% Confidence interval (CI) (0.552 to 0.996) (P = 0.047).
Conclusion: Regional block is associated with a reduction in the occurrence of postoperative complications graded by C-D classification in elderly patients with thoracic and abdominal cancer. The application of regional blocks can lower the risk of high-risk complications and mortality.
Keywords: Clavien-Dindo classification; cancer; old age; pain; postoperative complications; regional block.
Copyright © 2023 Ding, Zhang, Liu, Zhou, Zhao, Feng and An.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Figures
Similar articles
-
How Do Complications Within the First 30 days after Spinal Deformity Surgery in Children with Cerebral Palsy Affect Length of Stay?Clin Orthop Relat Res. 2021 Feb 1;479(2):366-375. doi: 10.1097/CORR.0000000000001290. Clin Orthop Relat Res. 2021. PMID: 32398555 Free PMC article.
-
Associations of Postoperative Complications Assessed by Clavien-Dindo Classification and Comprehensive Complication Index with Long-Term Overall Survival in Elderly Patients after Radical CRC Resection.Clin Interv Aging. 2020 Oct 13;15:1939-1949. doi: 10.2147/CIA.S271969. eCollection 2020. Clin Interv Aging. 2020. PMID: 33116448 Free PMC article.
-
The psoas muscle density as a predictor of postoperative complications in elderly patients undergoing rectal cancer resection.Front Oncol. 2023 Sep 14;13:1189324. doi: 10.3389/fonc.2023.1189324. eCollection 2023. Front Oncol. 2023. PMID: 37781186 Free PMC article.
-
Systematic assessment of complications after laparoscopic colorectal surgery for advanced colorectal cancer: A retrospective study using Clavien-Dindo classification, 5-year experience.Malawi Med J. 2022 Mar;34(1):49-52. doi: 10.4314/mmj.v34i1.9. Malawi Med J. 2022. PMID: 37265825 Free PMC article.
-
[Analysis of risk factors of severe postoperative complications in elderly patients with colorectal cancer aged over 80 years].Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Jul 25;23(7):695-700. doi: 10.3760/cma.j.cn.441530-20190814-00308. Zhonghua Wei Chang Wai Ke Za Zhi. 2020. PMID: 32683832 Chinese.
References
-
- De Oliveira GS, Jr., Castro-Alves LJ, Nader A, Kendall MC, McCarthy RJ. Transversus abdominis plane block to ameliorate postoperative pain outcomes after laparoscopic surgery: a meta-analysis of randomized controlled trials. Anesth Analg (2014) 118(2):454–63. doi: 10.1213/ANE.0000000000000066 - DOI - PubMed
LinkOut - more resources
Full Text Sources
Miscellaneous