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| Perioperative managements and construction of risk assessment system based on the preoperative risk factors |
| 1YuDingye,2YuZhen,1CaiWei |
| 1 Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China; 2 Depart?
ment of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China |
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Abstract Complications can occur after any abdominal surgery. Complications include incision infection, pneumonia,
urinary tract infection, enteroplegia and so on, which may increase the length of hospital stay and mortality. How to prevent
surgical complications has become a difficult problem for surgeons. Through a large number of literature studies and the research
results of our team, we integrated and classified the risk factors that may affect the prognosis of patients preoperatively, and then
screened out the independent risk factors which correlated with postoperative complications, postoperative fatigue syndrome
postoperative ileus and so on, including sarcopenia, visceral fat area/total abdominal muscle area, old age, anemia,
hypoproteinemia, NRS 2002 score≥3, ASA grade≥3, gastrectomy, open surgery, duration of operation≥4 hours, TNM stage≥ stage
Ⅲ and postoperative opioids use≥0.3 mg/kg. From the multi⁃dimensional integration of medical treatment, nursing, anesthesia,
and education, we concluded that the five major factors such as sarcopenia diagnosis, nutritional risk, anesthesia, past medical
history and surgery are the key points to prevent postoperative complications, and constructed a multi⁃dimensional model diagram
of the postoperative complication prevention system in order to take effective preventive measures earlier and provide a basis for
clinical prediction of the risk of surgical complications, which is significantly important for avoiding postoperative complications.
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Received: 15 May 2021
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