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| 1 | Risk-adjustment in hepatobiliarypancreatic surgery显示文摘AIM: The present study evaluates the performance of the POSSUM, the American Society of Anesthetists (ASA),APACHE and Childs classification in predicting mortality and morbidity in hepatopancreaticobiliary (HPB) surgery.We describe especially the limitations and advantages of risk in stratifying the patients.METHODS: We investigated 177 randomly chosen patients undergoing eledive complex HPB surgery in a single institution with a total of 71 pre-operative and intra-operative risk factors.Primary endpoint was in-hospital mortality and morbidity.Ordered logistic regression analysis was used to identify individual predictors of operative morbidity and mortality.RESULTS: The operative mortality in the series was 3.95% .This compared well with the p-POSSUM and APACHE predicted mortality of 4.31% and 4.29% respectively. Postoperative complications amounted to 45% with 24 (13.6%)patients having a major adverse event. On multivariate analysis the pre-operative POSSUM physiological score (OR = 1.18,P = 0.009) was superior in predicting complications compared to the ASA (P = 0.108), APACHE (P = 0.117)or Childs classification (P = 0.136). In addition, serum sodium, creatinine, international normalized ratio (INR),pulse rate, and intra-operative blood loss were independent risk factors. A combination of the POSSUM variables and INR offered the optimal combination of risk factors for risk prognostication in HPB surgery.CONCLUSION: Morbidity for elective HPB surgery can be accurately predicted and applied in everyday surgical practice as an adjunct in the process of informed consent and for effective allocation of resources for intensive and high-dependency care facilities. | Hemant M Kocher Paris P Tekkis Palepu Gopal Ameet G Patel Simon Cottam Irving S Benjamin | 2005 | World Journal of Gastroenterology2005，11，16： | 3 |
| 2 | benzyl ]-2, 4-thiazolidinedionesas potent antihyperglycemic agents显示文摘 | Cantello B C Cawthome M A Cottam G P | 1994 | J Med Chem1994，37，23： | 1 |
| 3 | benzyl-2, 4-thiazolidinediones as potent antihyperglycemic agents显示文摘 | Cawthorne M A Cottam G P | 1994 | J Med Chem1994，37，： | 1 |
| 4 | -benzyl]-2,4-thiazolidinediones as potent antihyperglycemic agents显示文摘 | CANTELLO B C C CAWTHORNE M A COTTAM G P | 1994 | J Med Chem1994，37，11： | 1 |
| 5 | Effecttive treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass显示文摘 | Eid G M Cottam D R Velcu L M | 2005 | Surg Obesity Related Dis2005，1，2： | 1 |
| 6 | 显示文摘 | | 1983 | Solid State Commun1983，45，： | 1 |
| 7 | Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass 显示文摘 | Eid G M Cottam D R Velcu L M | 2005 | Surgery for Obesity and Related Disease2005，1，2： | 1 |
| 8 | benzyl]-2,4-thiazolidinedio-nes as potent antihyperglycemic agents显示文摘 | Cantello B C C Cawthorne M A Cottam G P | 1994 | J Med Chem1994，37，23： | 1 |
| 9 | Vegetational response to climate and firein the driftless area of Wisconsin显示文摘 | Kline V M Cottam G | 1979 | Ecology1979，60，5： | 1 |
| 10 | Theory of elementary excitations in quasiperiodic structures显示文摘 | Albuquerque E L Cottam M G | 2003 | Physics Reports2003，376，45： | 1 |
| 11 | Ⅱ w- (Hererocyclylamino) alkoxy ] benzyl ] -2,4-thiazolidin- ediones as potent anfihyperglycemic agents 显示文摘 | Cantello C Cawthome M Cottam G | 1994 | J Med Chem1994，37，： | 1 |
| 12 | SPill waves iI1 Heisen- berg antiterromagnetic/ilms with (001), (011), and (111) surfaces显示文摘 | MILTON P Z J COTTAM M G | 2001 | Journal of Magnetic and Magnetic Materials2001，，： | 1 |
| 13 | Theory of elementary excitations in quasiperiodic structures 显示文摘 | Albuquerque E L Cottam M G | 2003 | Physics Reports2003，376，45： | 1 |
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