Perioperative Laboratory Abnormalities in Gynecologic Oncology Surgical Patients

Burnett, Tatnai L.; Junn, Justin; Kolenic, Giselle; Christen, Catherine; Johnston, Carolyn; Reynolds, R. Kevin; McLean, Karen

doi:10.1089/gyn.2015.0106

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…We found in the NSQIP data that the prevalence of preoperative hyponatremia was 8.4% in women with ovarian, PPC, and FT cancer undergoing cytoreductive surgery. (16) Prior studies of patients with malignant ascites have suggested that malignancies secrete factors that increase vascular permeability, leading to fluid accumulation. (17) This could create hypovolemic hyponatremia due to the leaching of fluid into the peritoneal cavity in the context of increased satiety and decreased oral intake, symptoms commonly seen with advanced ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?

Martin

Goff

Urban

2016

Gynecologic Oncology

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Objective-To determine if preoperative hyponatremia in women with ovarian, fallopian tube (FT), and primary peritoneal cancers (PPC) is associated with postoperative complications. Methods-We performed a retrospective population-based cohort study of women with a postoperative diagnosis of ovarian, FT, or PPC who had a cytoreductive procedure in the National Surgical Quality Improvement Program (NSQIP) database from 2005-2013. The primary exposure, preoperative sodium, was classified as normal (135mEq/L-142mEq/L) or hyponatremic (≤134mEq/L). Where appropriate, preoperative characteristics were compared with Chi-squared or Fisher's exact tests. Multivariate logistic regression was used to determine adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results-4009 subjects met inclusion criteria. Thirty day mortality was higher in the hyponatremic group compared to the normal serum sodium group (3.56% vs 1.18%). When patients of any age were noted to have at least two pertinent preoperative lab abnormalities, including hyponatremia, there was an increased risk of postoperative complications for patients over the age of 65. After adjusting for serum albumin and other confounders, preoperative hyponatremia was associated with an increased risk of hospital stay of >14 days (aOR 1.69; 95% CI 1.11-2.57) and 30 day postoperative mortality (aOR 2.37; 95% CI 1.13-4.98). Conclusions-Hyponatremia is associated with postoperative 30 day mortality and morbidity in women with ovarian, FT, and PPC. Serum sodium in conjunction with other markers may have the potential to identify candidates for neoadjuvant chemotherapy. Additional work is needed to determine if correction of hyponatremia in the preoperative period alters outcomes.

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Section: Discussionmentioning

confidence: 99%

Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?

Martin

Goff

Urban

2016

Gynecologic Oncology

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“…This information can be used by the surgeon to prepare the woman for operation and to plan for any preoperational measures necessary to avoid or manage complications. (9).…”

Section: Discussionmentioning

confidence: 99%

Risk factors, clinical outcome and complications of Common Gynecological Surgeries at Zagazig University Hospital, Egypt

Ibrahim

Abdalla²

2021

Preprint

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In present era, with the availability of better health care facilities and understanding of health issues, women are experiencing longer life expectancy and using more gynecological services, so obviously there is increase in gynecological surgeries. Any surgical procedure carries risks of complications. The risk of postoperative complications depends on individual characteristics, including age, medical comorbidities, and functional status. The aim of study was to reduce rates of mortality/morbidity among women who undergo surgical gynecological intervention at Zagazig University Hospital. This study included 212 cases were retrived prospectively in a cross sectional study. They underwent gynecological interventions. Our study group was 212 cases 24 cases ended with morbidity with percentage of 11.3% and 2 cases ended by death with percentage of 0.9% . This study shows that the most frequent complications among the studied group were septic wound infection (2.4%), bladder injury (2.4%), respiratory tract infection (1.9%),Venous thromboembolism(VTE) (1.9%) and GIT injury (1.4%). This study explains that there were two mortality cases the first case died on table due to primary hemorrhage during hysterectomy operation as a result of great vessel injury and the other case died during hysterectomy operation due to venous thromboembolic catastrophe (Pulmonary embolism). During post-operative period, she developed hypoxia; therefore, she was referred to ICU. Unfortunately, the patient was diagnosed as pulmonary embolism; thus, she was admitted at ICU for 3 days, but she finally died. Conclusion With the availability of highly skilled personnel with improved surgical expertise, safe anesthesia and collaboration of other specialized medical personnel, the major complications and mortality rate will decrease, but the postoperative complications like, fever, respiratory tract infection, septic wound and DVT still frequent in a significant number of patients in our community, which brings about much distress to the patients.

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Section: Discussionmentioning

confidence: 99%

Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?

Martin

Goff

Urban

2016

Gynecologic Oncology

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Objective To determine if preoperative hyponatremia in women with ovarian, fallopian tube (FT), and primary peritoneal cancers (PPC) is associated with postoperative complications. Methods We performed a retrospective population-based cohort study of women with a postoperative diagnosis of ovarian, FT, or PPC who had a cytoreductive procedure in the National Surgical Quality Improvement Program (NSQIP) database from 2005-2013. The primary exposure, preoperative sodium, was classified as normal (135mEq/L - 142mEq/L) or hyponatremic (≤134mEq/L). Where appropriate, preoperative characteristics were compared with Chi-squared or Fisher’s exact tests. Multivariate logistic regression was used to determine adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results 4009 subjects met inclusion criteria. Thirty day mortality was higher in the hyponatremic group compared to the normal serum sodium group (3.56% vs 1.18%). When patients of any age were noted to have at least two pertinent preoperative lab abnormalities, including hyponatremia, there was an increased risk of postoperative complications for patients over the age of 65. After adjusting for serum albumin and other confounders, preoperative hyponatremia was associated with an increased risk of hospital stay of >14 days (aOR 1.69; 95% CI 1.11-2.57) and 30 day postoperative mortality (aOR 2.37; 95% CI 1.13-4.98). Conclusions Hyponatremia is associated with postoperative 30 day mortality and morbidity in women with ovarian, FT, and PPC. Serum sodium in conjunction with other markers may have the potential to identify candidates for neoadjuvant chemotherapy. Additional work is needed to determine if correction of hyponatremia in the preoperative period alters outcomes.

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Perioperative Laboratory Abnormalities in Gynecologic Oncology Surgical Patients

Cited by 6 publications

References 18 publications

Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?

Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?

Risk factors, clinical outcome and complications of Common Gynecological Surgeries at Zagazig University Hospital, Egypt

Preoperative hyponatremia in women with ovarian cancer: An additional cause for concern?

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