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Evaluation of Gastroesophageal Reflux and Hiatal Hernia as Risk Factors for Lobectomy Complications
Evaluation of Gastroesophageal Reflux and Hiatal Hernia as Risk Factors for Lobectomy Complications
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20250211151051
- ISBN
- 9798382321493
- DDC
- 610
- 서명/저자
- Evaluation of Gastroesophageal Reflux and Hiatal Hernia as Risk Factors for Lobectomy Complications
- 발행사항
- [Sl] : Yale University, 2024
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2024
- 형태사항
- 52 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 85-11, Section: B.
- 주기사항
- Advisor: Boffa, Daniel J.
- 학위논문주기
- Thesis (M.D.)--Yale University, 2024.
- 초록/해제
- 요약Up to 40% of lobectomies are complicated by adverse events. Gastroesophageal reflux disease (GERD) and hiatal hernia have been associated with cardiopulmonary pathology across a range of clinical scenarios, yet their relation to complications after pulmonary resection is understudied. We hypothesized GERD and hiatal hernia are predictors of complications after lobectomy for lung cancer. Lobectomy patients at Yale-New Haven Hospital between January 2014 and April 2021 were evaluated for predictors of 30-day post-operative complications, pneumonia, atrial arrhythmia, readmission, and mortality. Multivariable regression models included sociodemographic characteristics, BMI, surgical approach, cardiopulmonary comorbidities, hiatal hernia, GERD, and acid suppressive therapy as predictors. Overall, 824 patients underwent lobectomy, including 50.5% with a hiatal hernia and 38.7% with GERD. The median age was 68 [IQR 61-74] years and the majority were female (58.4%). At least one postoperative complication developed in 39.6% of patients, including atrial arrhythmia (11.7%) and pneumonia (4.1%). Male sex (OR 1.51, 95% CI [1.11-2.06], p=.01), age ≥70 years (OR 1.55, 95% CI [1.13-2.11], p=.01), hiatal hernia (OR 1.40, 95% CI [1.03-1.90], p=.03), and intraoperative packed RBCs (OR 4.80, 95% CI [1.51-15.20], p=.01) were significant risk factors for developing at least one postoperative complication. Hiatal hernia was also a significant predictor of atrial arrhythmia (OR 1.64, 95% CI [1.02-2.62], p=.04) but was not associated with other adverse events. Our findings indicate that hiatal hernia may be a novel risk factor for complications, especially atrial arrhythmia, following lobectomy that should be considered in the preoperative evaluation of lung cancer patients.
- 일반주제명
- Medicine
- 일반주제명
- Oncology
- 일반주제명
- Surgery
- 키워드
- Lung cancer
- 키워드
- Hiatal hernia
- 기타저자
- Yale University Yale School of Medicine
- 기본자료저록
- Dissertations Abstracts International. 85-11B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■020 ▼a9798382321493
■035 ▼a(MiAaPQ)AAI31141450
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610
■1001 ▼aKaminski, Michael.
■24510▼aEvaluation of Gastroesophageal Reflux and Hiatal Hernia as Risk Factors for Lobectomy Complications
■260 ▼a[Sl]▼bYale University▼c2024
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2024
■300 ▼a52 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-11, Section: B.
■500 ▼aAdvisor: Boffa, Daniel J.
■5021 ▼aThesis (M.D.)--Yale University, 2024.
■520 ▼aUp to 40% of lobectomies are complicated by adverse events. Gastroesophageal reflux disease (GERD) and hiatal hernia have been associated with cardiopulmonary pathology across a range of clinical scenarios, yet their relation to complications after pulmonary resection is understudied. We hypothesized GERD and hiatal hernia are predictors of complications after lobectomy for lung cancer. Lobectomy patients at Yale-New Haven Hospital between January 2014 and April 2021 were evaluated for predictors of 30-day post-operative complications, pneumonia, atrial arrhythmia, readmission, and mortality. Multivariable regression models included sociodemographic characteristics, BMI, surgical approach, cardiopulmonary comorbidities, hiatal hernia, GERD, and acid suppressive therapy as predictors. Overall, 824 patients underwent lobectomy, including 50.5% with a hiatal hernia and 38.7% with GERD. The median age was 68 [IQR 61-74] years and the majority were female (58.4%). At least one postoperative complication developed in 39.6% of patients, including atrial arrhythmia (11.7%) and pneumonia (4.1%). Male sex (OR 1.51, 95% CI [1.11-2.06], p=.01), age ≥70 years (OR 1.55, 95% CI [1.13-2.11], p=.01), hiatal hernia (OR 1.40, 95% CI [1.03-1.90], p=.03), and intraoperative packed RBCs (OR 4.80, 95% CI [1.51-15.20], p=.01) were significant risk factors for developing at least one postoperative complication. Hiatal hernia was also a significant predictor of atrial arrhythmia (OR 1.64, 95% CI [1.02-2.62], p=.04) but was not associated with other adverse events. Our findings indicate that hiatal hernia may be a novel risk factor for complications, especially atrial arrhythmia, following lobectomy that should be considered in the preoperative evaluation of lung cancer patients.
■590 ▼aSchool code: 0265.
■650 4▼aMedicine
■650 4▼aOncology
■650 4▼aSurgery
■653 ▼aLung cancer
■653 ▼aCardiopulmonary pathology
■653 ▼aHiatal hernia
■653 ▼aGastroesophageal reflux disease
■690 ▼a0564
■690 ▼a0576
■690 ▼a0992
■71020▼aYale University▼bYale School of Medicine.
■7730 ▼tDissertations Abstracts International▼g85-11B.
■790 ▼a0265
■791 ▼aM.D.
■792 ▼a2024
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17160627▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
