Demographic and preoperative factors associated with failure of enhanced recovery protocol after major hepatobiliary and pancreatic surgery
| Enhanced recovery protocol groups | p Value | ||
|---|---|---|---|
| Failure (n=25) | Success (n=169) | ||
| Mean age (SD), years | 57 (11) | 59 (11) | 0.498 |
| Males, n (%) | 19 (76) | 131 (78) | 0.866 |
| American Society of Anesthesiologists’ Physical Status, n (%) | |||
| I | 2 (8) | 25 (15) | 0.512 |
| II | 18 (72) | 121 (72) | |
| III/IV | 5 (20) | 23 (14) | |
| Current smoker, n (%) | 9 (36) | 35 (21) | 0.088 |
| Median adjusted cotinine, ng/mL (IQR) | 1.34 (0.60–265.82) | 1.07 (0.55–3.51) | 0.183 |
| Type of surgery, n (%) | |||
| Exploratory | 1 (4) | 5 (3) | 0.441 |
| Laparoscopic liver resection | 3 (12) | 28 (17) | |
| Minor open liver resection | 5 (20) | 62 (37) | |
| Major open liver±biliary reconstruction | 12 (48) | 52 (31) | |
| Whipple | 2 (8) | 15 (9) | |
| Other pancreatic surgery | 2 (8) | 7 (4) | |
| Magnitude of surgery, n (%) | |||
| Major | 4 (16) | 36 (21) | 0.541 |
| Ultramajor | 21 (84) | 133 (79) | |
| Low albumin (<35 g/L), n (%) | 2 (4) | 12 (7) | 0.698 |
| High bilirubin (µmol/L),* n (%) | 7 (28) | 27 (16) | 0.159 |
| Alkaline phosphatase (IU/L), n (%) | |||
| Normal† | 14 (56) | 123 (73) | 0.214 |
| Low | 1 (4) | 3 (2) | |
| High | 10 (40) | 43 (25) | |
| High ALT/GPT (IU/L), ‡ n (%) | 11 (44) | 23 (14) | 0.001 |
| Haemoglobin (g/dL), n (%) | |||
| Normal§ | 14 (56) | 121 (72) | 0.211 |
| Low | 10 (40) | 46 (27) | |
| High | 1 (4) | 2 (1) | |
| Platelets, n (%) | |||
| Normal (150–384×109/L) | 14 (56) | 117 (69) | 0.294 |
| Low | 10 (40) | 50 (30) | |
| High | 1 (4) | 2 (1) | |
| Prothrombin time, n (%) | |||
| Normal (9.5–12 s) | 19 (76) | 144 (85) | 0.423 |
| Low | 0 (0) | 1 (1) | |
| High | 6 (24) | 24 (14) | |
| Activated partial thromboplastin time, n (%) | |||
| Normal (28.2–37.4 s) | 22 (88) | 153 (91) | 0.914 |
| Low | 2 (8) | 10 (6) | |
| High | 1 (4) | 6 (4) | |
| High international normalised ratio, n (%) | 0 (0) | 2 (1) | 1.000 |
| Urinary creatinine (µmol/L), n (%) | |||
| Normal† | 20 (80) | 143 (85) | 0.815 |
| Low | 3 (12) | 17 (10) | |
| High | 2 (8) | 9 (5) | |
*High bilirubin defined as more than 19 µmol/L in men and more than 17 µmol/L in women.
†Age-specific and gender-specific range.
‡High ALT/GPT defined as more than 67 IU/L in men and more than 55 IU/L in women.
§Normal range is 13.2–17.2 g/dL for men and 11.9–15.1 g/dL for women.
ALT/GPT, alanine transaminase/glutamic-pyruvic transaminase.