AB43. Analysis of reason and prognosis for patients with gastric cancer transferred ICU after operation (clinical analysis of 147 cases)

Objective: This study aims at retrospectively analyzing related factors for patients with gastric cancer transferred to ICU after operation and providing the evidences for better treatment of patients by collecting clinical data of patients transferred to ICU.

Methods: Patients diagnosed with gastric cancer received operation in general surgery of the Fourth Hospital of Hebei Medical University from 1993 to 2010 were selected. The influence factors of patients transferred to the ICU for transitional treatment after operation (such as patients’ gender, age, medical history, preoperative hemoglobin, preoperative albumin, resection degree in operation, the amount of blood loss during operation, secondary surgery history, etc), the reasons of the therapeutic purposes to transfer to ICU after operation (such as heart failure, respiratory failure, shock, etc), the causes of death and the hospital stays of patients transferred to ICU after operation were collected.

Results: There were significant differences between the groups of gender, age, concomitant diseases, preoperative anemia, preoperative low protein, operation method, combined multiple organs resection, intraoperative bleeding, unplanned reoperation and postoperative complications. There was no significant difference between the groups of history of previous abdominal surgery, nature of operation, prognosis and number of days in hospital.

Conclusions: More postoperative gastric cancer male patients were transferred to ICU than the female. When patients have some risk factors, such as the elderly (>70 years old), preoperative combined heart and lung disease, preoperative anemia, preoperative low protein, intraoperative hemorrhage or 400 mL, intraoperative multi-visceral resection, and secondary surgery, they should be considered to be transferred to the ICU for transitional treatment. It was advantageous for the rehabilitation of patients. The mortality rate of postoperative patients transferred to the ICU for transitional treatment was lower than those transferred to the ICU for therapeutic purposes, but there was no significant difference in statistics. Hospitalization days and time transferred to the ICU had no obvious relation with each other. But hospital days of postoperative patients transferred to the ICU for transitional treatment was significantly shortened than thosed transferred to the ICU for therapeutic purposes.

Keywords: Gastric cancer; ICU; perioperative; old age; comorbidities; complications