Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MORBIDITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed2001

Health findings from a mortality and morbidity surveillance of refinery employees.

PURPOSE: To present results from a prospective mortality (1973-1998) and morbidity (1990-1998) surveillance of a refinery population in California. METHODS: Mortality and illness-absence data were extracted from the Shell Oil Company's Health Surveillance System (HSS). Mortality data were compared to the United States, the state of California, and Contra Costa County, where the refinery is located. Morbidity data were compared to other company manufacturing employees. The standardized mortality/morbidity ratio (SMR/SMbR) was used as a measure of risk. Morbidity frequency and duration of absence were calculated by age, sex, and four health risk factors (smoking, high blood pressure, hypercholesterolemia, and obesity). RESULTS: With the United States as a comparison, the all causes combined SMR was 0.84 [95% confidence interval (CI) = 0.78-0.90], and the SMR for all cancer was 0.75 (95% CI = 0.64-0.88). Statistically significant deficits in mortality were found for lung cancer (SMR = 0.60) and leukemia (SMR = 0.26). Morbidity frequency and duration of absence among smokers were substantially higher than those of nonsmokers. Similar results were also noted for obese employees when compared to those of normal weight. CONCLUSIONS: Regardless of the comparison population, significantly fewer deaths were seen for all causes combined, all cancer, lung cancer, and leukemia. The study also showed no increased mortality from cancer of the stomach, kidney, skin, prostate, and brain. The increased morbidity frequency and duration of absence were associated with the presence of known health risk factors. These study findings are useful in setting priorities for medical programs and directing efforts such as health promotion and disease prevention strategies.

Adult↗
PubMed2003

The prevention and management of treatment related morbidity in vulval cancer.

The traditional and the most common management of primary vulval cancer is radical surgery of the vulva and radical groin lymphadenectomy (unilateral or bilateral). Adjuvant radiotherapy is used in poor prognosis cases. Rare vulval cancers, locally advanced cancers and recurrent vulval cancers often are treated with a combination of surgery, radiation therapy and chemotherapy. The treatments, while often curative, are associated with considerable morbidity, which, until recently, has not been well publicized or quantified. Increasingly, younger patients are presenting with extensive and often multi-focal pre-invasive disease and with vulval cancer. Long-term post-treatment physical, sexual and psychological morbidity is of major concern. There is more onus on clinicians to provide less radical but equally curative treatment, while also reducing morbidity. There is also the need to provide treatment and treatment modification based on supporting evidence. For a rare disease such as vulval cancer it is more difficult to generate data and to conduct trials on treatment modifications. Although surgical modifications have been made, the morbidity of radical surgery for vulval cancer is considerable. The prevention and management of treatment-related morbidity will continue to challenge the gynaecological oncology team.

Aged↗
PubMed1992

Child morbidity patterns in Ethiopia.

This study is based on the 1983 Rural Health Survey of Ethiopia. Patterns and levels of child morbidity by age, sex, geographic region, and sanitary facilities are examined. Morbidity levels peak in the second year of life. Diarrhoeal diseases are of major importance, especially among infants and toddlers. Parasitic diseases, and respiratory diseases other than pneumonia, become increasingly important with age. There are no significant sex differentials in morbidity except for higher rates of diarrhoeal diseases among female children. Geographic differentials are quite marked with particularly high morbidity levels from all disease types in the western mountainous regions of Ethiopia. Access to high quality drinking water, a latrine, and garbage disposal, are strongly related to reduced overall morbidity levels, though not necessarily to reduced diarrhoeal disease levels.

Child, Preschool↗
PubMed1993

Hemodialysis vascular access morbidity in the United States.

Extensive morbidity related to hemodialysis vascular access exists among end-stage renal disease (ESRD) patients, but the risk factors for this morbidity have not been extensively studied. Medicare ESRD patient data were obtained from 1984, 1985, and 1986. Hospitalization for vascular access morbidity (ICD-996.1, 996.6, or 996.7) was analyzed among prevalent patients and, using survival analysis, among incident patients to assess sex, age, race, and underlying cause of renal failure as risk factors. We found that 15 to 16% of hospital stays among prevalent ESRD patients were associated with vascular access-related morbidity. Black race, older age, female sex, and diabetes mellitus as a cause of kidney failure were all independent risk factors for access-related morbidity. The rate ratio comparing Blacks to Whites was 1.12 (95% C.I., 1.09, 1.16); > 64 years to 20 to 44 years, 1.53 (1.46, 1.59); men to women, 0.81 (0.79, 0.84); and diabetes to glomerulonephritis, 1.29 (1.24, 1.35). We conclude that hemodialysis vascular access malfunction causes much hospitalization among ESRD patients. Women, Blacks, the elderly, and diabetics appear to be at particularly high risk, and additional studies are needed to understand these patterns.

Adult↗
PubMed2006

Size and morbidity in Malawian twins.

OBJECTIVE: Twins in developing countries may be disadvantaged due to their small size at birth, compromised nutrition and high infection risk. Although twinning is common in Africa, there are few longitudinal studies of growth and morbidity in this high-risk group. The aim of the present paper was to describe growth and morbidity of Malawian twins compared to singletons. METHODS: Morbidity episodes were recorded at 4 weekly intervals and at extra visits made to health centres for illness. Weight, length, head and arm circumference were recorded at birth and weight, length and MUAC at 4 weekly intervals to 52 weeks of age. RESULTS: Twins showed reduced fetal growth compared to singletons, with increasing fall-off in percentiles from 33 weeks gestation. Infant growth percentiles for twins were below those for singletons at all ages, but showed no fall-off from singleton percentile values. There were no differences in morbidity incidence during infancy between twins and singletons. CONCLUSION: Malawian twins showed no catch-up growth during infancy, their smaller size was not associated with higher morbidity incidence compared to singletons.

Birth Weight↗
PubMed1998

Effects of surgically induced weight loss on urinary bladder pressure, sagittal abdominal diameter and obesity co-morbidity.

OBJECTIVE: Evaluate the effects of surgically induced weight loss on intra-abdominal pressure at one year, reflected in urinary bladder pressure, central obesity, measured by sagittal abdominal diameter and obesity co-morbidity. DESIGN: Prospective, non-randomized trial. SETTING: University Hospital, Operating Room, In-patient, Outpatient Clinics. SUBJECTS: Gastric bypass in 15 severely obese patients. MEASUREMENTS: Patients underwent pre-operative assessment of weight, body mass index (BMI), co-morbid history, urinary bladder pressure and sagittal abdominal diameter. Patients were reassessed one year after gastric bypass with repeat measurement of weight, bladder pressure, and sagittal abdominal diameter and assessment of co-morbidity. RESULTS: There were significant (P < 0.001) decreases in weight (140+/-8 - 87+/-6 kg), BMI (52+/-3 - 33+/-2 kg/m2), sagittal abdominal diameter (32+/-1 - 20+/-2 cm), urinary bladder pressure (17+/-2 - 10+/-1 cm H2O) and obesity related problems per patient (2.9+/-0.4 - 1+/-0.2) one year after gastric bypass, with 69+/-4% loss of excess weight. CONCLUSIONS: Increased sagittal abdominal diameter is associated with increased intra-abdominal pressure which contributes to obesity related co-morbidity. Weight loss following gastric bypass decreases abdominal pressure, sagittal abdominal diameter and obesity co-morbidity.

Abdomen↗
PubMed2003

Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding.

OBJECTIVE: We measured markers of acute-phase response and immunological markers in morbid obese patients and in formerly morbid obese patients after a massive weight loss following adjustable gastric banding (GB). SUBJECTS: A total of 49 morbid obese female patients with a body mass index (BMI) above 40 kg/m(2) were investigated during a study period of 6 months. Of these, 24 patients received a gastric banding (GB) and lost a minimum of 20 kg in 1 y (GB group) and 25 patients maintained their weight (obese group). In sum, 13 normal weight subjects (BMI<24 kg/m(2)) were taken for controls. METHOD: Plasma concentration of the acute-phase proteins, C-reactive protein (CRP), orosomucoid, complement factors C3 and C4 and white blood cell count, lymphocyte subsets and serum immunoglobulins were analyzed. RESULTS: Acute-phase proteins were significantly lower in GB compared to morbid obese patients and remained significantly elevated in GB compared to controls. In addition, leukocytes, polymorphonuclear leukocytes and lymphocytes were significantly lower after GB and reached levels comparable to controls (except PMN). No difference in CD3 counts was observed in the three groups. CD4 increased and CD8 decreased in obese and GB patients when compared to controls whereas no statistical difference was found between obese and GB patients. CONCLUSION: Our results confirm the positive effect of GB followed by a massive weight loss without apparent malnutrition. Subclinical chronical inflammation in morbid obese patients leads to irregularities in leukocyte and lymphocyte subsets. These alterations can be positively influenced by GB.

Acute-Phase Proteins↗
PubMed2003

Clinical and cost effectiveness of surgery for morbid obesity: a systematic review and economic evaluation.

OBJECTIVE: To assess the clinical and cost effectiveness of surgery for people with morbid obesity. DESIGN: A systematic review of randomised control trials (RCTs), prospective clinical trials and economic evaluations identified from 14 electronic databases (including Medline, Cochrane library and Embase from their inception to October 2001), bibliographies and consultation with experts and manufacturers was performed to assess the clinical and cost effectiveness of different surgical procedures and nonsurgical management for morbid obesity. An economic evaluation was undertaken to assess cost effectiveness in the UK. SUBJECTS: People diagnosed as morbidly obese, defined as a body mass index (BMI) (weight in kilograms/height in metres(2)) >40 kg/m(2), or with a BMI>35 kg/m(2) with serious comorbid disease, in whom previous nonsurgical interventions had failed. MEASUREMENTS: The outcomes assessed included weight change, quality of life, peri- and postoperative morbidity and mortality, revision rates and obesity comorbidities. Cost effectiveness was modelled from these data and presented as cost per quality-adjusted life year (QALY). RESULTS: Included studies differed in methodological quality. Surgery resulted in a significantly greater loss of weight (23-37 kg more weight) than nonsurgical treatment, which was maintained to 8 years and led to improvements in quality of life and comorbidities. The economic evaluation of surgery compared with nonsurgical management suggested that surgery was cost effective at pound 11000 per QALY. Comparisons of the different types of surgery were equivocal. CONCLUSION: Surgery for morbid obesity appears to be clinically and cost effective. Because of the nature of the evidence, particularly the uncertainty in the clinical and economic evaluations, it is difficult to distinguish between the different surgical procedures.

Cost-Benefit Analysis↗
PubMed2006

A descriptive model of preventability in maternal morbidity and mortality.

OBJECTIVE: To develop a descriptive model of preventability for maternal morbidity and mortality that can be used in quality assurance and morbidity and mortality review processes. STUDY DESIGN: This descriptive study was part of a larger case-control study conducted at the University of Illinois at Chicago in which maternal deaths were cases and women with severe maternal morbidity served as controls. Morbidities and mortalities were classified by a team of clinicians as preventable or not preventable. Qualitative analysis of data was conducted to identify and categorize different types of preventable events. RESULTS: Of 237 women, there were 79 women with preventable events attributable to provider or system factors. The most common types of preventable events were inadequate diagnosis/recognition of high-risk (54.4%), treatment (38.0%), and documentation (30.7%). CONCLUSIONS: A descriptive model was illustrated that can be used to categorize preventable events in maternal morbidity and mortality and can be incorporated into quality assurance and clinical case review to enhance the monitoring of hospital-based obstetric care and to decrease medical error.

Adult↗
PubMed2002

Differences between Japanese pre-school and school-age pedestrian mortality and morbidity trends.

The risk of pedestrian injury during childhood in industrialised countries is decreasing in a trend that is related to exposure to traffic. Examining the differences between age groups and their behaviour provides an insight into exposure to risks. Using data for the period 1968-1998, we compared the changes in pedestrian mortality and morbidity in pre-school children (aged 0-6) with those of school-age children (aged 7-12). Pedestrian mortality and morbidity decreased in children of all ages in the early 1970s. However, after the mid-1970s, both mortality and morbidity continued to decrease only in pre-schoolers. In school-age children, mortality continued to decrease but morbidity did not change. These age-related differences in mortality and morbidity indicate that over the past 30 y the environment for child pedestrians did not become safer. Instead, some of the decrease in children's injuries was probably achieved at the expense of their outdoor activities. Efforts to protect children from vehicular traffic should focus on changing the outdoor environment rather than on restricting children's activities.

Accidents, Traffic↗
PubMed1998

Increased leptin production in vivo and insulin cleavage by the omental adipose tissue of morbidly obese patients.

OBJECTIVE: The aim of this investigation was to assess the insulin cleavage capacity in obese humans. Increased insulin degradation by visceral adipose tissue has previously been demonstrated in obese rats and could be interpreted as a physiological response to hyperinsulinaemia. The recent characterization of leptin receptors in pancreatic beta cells, liver and muscle suggests that leptin may influence insulin function and metabolism. Our study focuses on the possible relationship between leptin secretion and adipose tissue insulin-degrading capacity. DESIGN AND PATIENTS: Insulin and leptin were measured in arterial blood and in the epiploic vein of morbidly obese (n = 7) and non-obese patients (n = 7) who were undergoing abdominal surgery. Arteriovenous insulin difference (AV insulin) was considered an in vivo marker of insulin degradation by the omental fat tissue. Statistical comparison between venous and arterial leptin was used to assess endogenous leptin production. MEASUREMENTS: Insulin was measured using an oligoclonal IRMA and leptin levels were determined by using a specific radioimmunoassay. RESULTS: Morbidly obese patients were hyperinsulinaemic compared to non-obese patients according to arterial insulin levels (P = 0.049) but not to venous levels. Insulin cleavage capacity, nil in the control group, was clearly significant in the morbidly obese patients (P = 0.001). In the morbidly obese group, leptin levels in venous epiploic samples were significantly higher (P = 0.028) than in the arterial samples, confirming in situ the synthesis of leptin by human white adipose tissue. We also observed a correlation between insulin arterial levels and venous leptin concentrations (P = 0.009) which supports the chronic leptinogenic effect of insulin suggested in previous works. Finally, our results show that venous leptin levels are correlated with the extent of insulin cleavage by omental tissue (P = 0.033). CONCLUSIONS: Morbidly obese patients have a higher white adipose tissue insulin cleavage capacity, which could partially diminish hyperinsulinaemia-derived adverse effects. High leptin production, a consequence of high insulin levels, may act as a signal to the insulin-degrading tissues in order to lower insulinaemia.

Adipose Tissue↗
PubMed2000

Hidden psychiatric morbidity in a vocational programme for people with intellectual disability.

The aim of the present study was to assess the point-prevalence of psychiatric disorders according to DSM-III-R criteria and the hidden morbidity in individuals with intellectual disability working in a vocational setting. The present study was carried out in a vocational centre in Southern Spain which is considered to be a model for social integration. One hundred and thirty workers with intellectual disability were interviewed by two experienced clinicians using the Assessment and Information Rating Profile, DSM-III-R criteria, and the General Assessment of Functioning and Clinical Global Impression scales. The point-prevalence of psychiatric morbidity, hidden morbidity and treatment adequacy were estimated. Morbidity was hidden (i.e. not previously diagnosed) in 50% of psychiatric cases. Forty-two (32.3%) subjects had a psychiatric diagnosis with the following distribution: schizophrenia (17.7%), other psychotic disorders (9.23%), mood disorders (4.61%), adaptive disorders (2.31%), anxiety disorders (1.54%) and other psychiatric disorders (6.15%). Treatment was judged inadequate in 30% of subjects. The point-prevalence of psychiatric problems in a vocational setting in Spain was similar to that found in other environments. Hidden morbidity was similar to that found in primary care. The present study highlights the need for standardized instruments for psychiatric assessment in non-clinical settings as well as specific training in this area.

Adolescent↗
PubMed1998

The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens.

AIMS: To evaluate the prognostic value of the QT interval and QT interval dispersion in total and in cardiovascular mortality, as well as in cardiac morbidity, in a general population. METHODS AND RESULTS: The QT interval was measured in all leads from a standard 12-lead ECG in a random sample of 1658 women and 1797 men aged 30-60 years. QT interval dispersion was calculated from the maximal difference between QT intervals in any two leads. All cause mortality over 13 years, and cardiovascular mortality as well as cardiac morbidity over 11 years, were the main outcome parameters. Subjects with a prolonged QT interval (430 ms or more) or prolonged QT interval dispersion (80 ms or more) were at higher risk of cardiovascular death and cardiac morbidity than subjects whose QT interval was less than 360 ms, or whose QT interval dispersion was less than 30 ms. Cardiovascular death relative risk ratios, adjusted for age, gender, myocardial infarct, angina pectoris, diabetes mellitus, arterial hypertension, smoking habits, serum cholesterol level, and heart rate were 2.9 for the QT interval (95% confidence interval 1.1-7.8) and 4.4 for QT interval dispersion (95% confidence interval 1.0-19-1). Fatal and non-fatal cardiac morbidity relative risk ratios were similar, at 2.7 (95% confidence interval 1.4-5.5) for the QT interval and 2.2 (95% confidence interval 1.1-4.0) for QT interval dispersion. CONCLUSION: Prolongation of the QT interval and QT interval dispersion independently affected the prognosis of cardiovascular mortality and cardiac fatal and non-fatal morbidity in a general population over 11 years.

Adult↗
PubMed2006

Maternal request cesarean versus planned spontaneous vaginal delivery: maternal morbidity and short term outcomes.

Since no randomized trial evaluates maternal morbidity from planned cesarean versus planned vaginal delivery, the issue must be addressed indirectly from retrospective cohort studies of vertex fetuses by actual or planned delivery route, and retrospective or randomized studies of breech fetuses by planned delivery route. The available data, although limited, suggest that term planned cesarean and planned vaginal delivery have similarly low rates of absolute and relative short-term maternal morbidity. Endometritis and cystitis are more frequent with cesarean, whereas hemorrhage is more frequent with planned vaginal delivery. Much of the morbidity of planned vaginal delivery is the morbidity of unplanned cesarean in labor and operative vaginal delivery, particularly forceps. Thus, the relative risk of short-term maternal morbidity of planned cesarean versus planned vaginal delivery will depend on the proportion of women in each group ultimately delivering in the planned manner and the frequency with which delivery occurs by an alternative unplanned method.

Cesarean Section↗
PubMed2003

CYP2E1 activity before and after weight loss in morbidly obese subjects with nonalcoholic fatty liver disease.

Previous studies suggest that hepatic cytochrome P450 2E1 (CYP2E1) activity is increased in individuals with chronic alcoholism, nonalcoholic steatohepatitis (NASH), and morbid obesity, and may contribute to liver disease. We studied 16 morbidly obese subjects with varying degrees of hepatic steatosis and 16 normal-weight controls. Obese subjects were evaluated at baseline, 6 weeks, and 1 year after gastroplasty, a procedure that leads to weight loss. Hepatic CYP2E1 activity was assessed by determination of the clearance of chlorzoxazone (CLZ), an in vivo CYP2E1-selective probe. Liver biopsy tissue was obtained during surgery for histopathology. Both the total and unbound oral CLZ clearance (Cl(u)/F) was elevated approximately threefold in morbidly obese subjects compared with controls (P <.001). The Cl(u)/F was significantly higher among subjects with steatosis involving >50% of hepatocytes, compared with those with steatosis in < or =50% of hepatocytes (P =.02). At postoperative week 6 and year 1, the median body mass index (BMI) of subjects who underwent gastroplasty decreased by 11% and 33%, total oral CLZ clearance declined by 16% (P <.01) and 46% (P <.05), and Cl(u)/F decreased by 18% (P <.05) and 35% (P =.16), respectively. Moreover, those subjects with a year 1 BMI <30 kg/m(2) exhibited a median Cl(u)/F that was 63% lower (P =.02) than the respective clearance for all other subjects. In conclusion, hepatic CYP2E1 activity is up-regulated in morbidly obese subjects. A positive association between the degree of steatosis and CYP2E1 activity preoperatively and between the extent of obesity and CYP2E1 activity postoperatively, suggests that CYP2E1 induction is related to or caused by hepatic pathology that results from morbid obesity.

Blood Glucose↗
PubMed1997

Heart surgery in patients aged eighty years and above: determinants of morbidity and mortality.

Escalating medical costs, limitation of resources and the necessity to provide cost-effective medical care have created a need for systematic risk stratification and cost-benefit analyses in the background of an ongoing discussion. Results of heart surgery in octogenarians have been evaluated in a prospective single-center, study since 1990. 101 consecutive patients (55/ 101 = 54.5% female) aged 80 years and above (median: 81 years; interquartile range [IQR]: 80.0-82.5, total range [TR]: 80-92 years) undergoing open heart surgery at our institution between January 1990 and March 1996 were included into this prospective study. Prior to surgery, most patients were severely symptomatic being in functional NYHA classes either III (56.4%) or IV (31.7%). 61/101 (60.4%) patients underwent isolated coronary artery bypass grafting (CABG), 23 (22.8%) had aortic valve replacement (AVR), 14 patients (13.9%) had CABG combined with AVR or double valve replacement and 3 (3.0%) had mitral valve repair. Follow-up (median: 23.0 months. IQR: 10.5-39.0, TR: 1-72) was focused on long-term morbidity and quality of life. The impact of preoperative and operative risk factors on morbidity and mortality was determined by uni- and multivariate statistical analysis. The 30-days overall mortality in this study was 7.9%. The postoperative course was uneventful for 27 (26.7%) of our patients. Univariate risk factors of postoperative mortality were: left main stem disease (p < or = 0.044), ejection fraction < 45% (p < or = 0.006), preoperative intensive care unit (ICU) (p < or = 0.002), urgent or emergency operation (p < or = 0.034). The only independent predictor of operative mortality was preoperative ICU-stay (p < or = 0.008). Significant risk factors for the number of postoperative complications in the multivariate analysis were: prior stroke (p < or = 0.04), diabetes mellitus (p < or = 0.02), New York Heart Association (NYHA) class IV symptoms (p < or = 0.002) and prolonged cross-clamping time (p < or = 0.001). Mean postoperative length of stay in the ICU was 3.9 +/- 3.9 days. Late morbidity was not related to postoperative complications. Cumulative survival was 87.9%, 79.5% and 72.9% at one, two or five years, respectively. After hospital discharge, 67/93 patients (82.8%) were in NYHA functional class I or II. Cardiac surgery in very elderly patients can be performed with acceptable operative risk and a favorable long-term outcome. The individual patient risk-profile including significant co-morbid conditions and severity of the heart disease predicts not only survival but the extent of perioperative morbidity.

Aged↗
PubMed1984

Morbidity in childhood--a longitudinal view.

We examined all the morbidity experienced in a six-year period by a total of 2591 children who were continuously enrolled in a prepaid medical plan. The children had received 19,291 diagnoses, each of which was assigned to one of 14 types of morbidity, and the frequency of each type was determined. Although the typical child had at least one problem in 5 of the 14 types of morbidity in the six-year period, over 20 per cent of children had at least 8 different types of problems during that time. Children with a greater variety of acute problems and more frequent acute problems were also more likely to have nonacute problems during the six-year period. Conversely, children with nonacute problems had more acute problems than other children. Our findings indicate that morbidity, like use of health services, occurred in clusters in this population of children. Therefore, an understanding of the cause and projected outcome of morbidity among children will be incomplete if the focus is only on specific diseases or specific types of illnesses.

Adolescent↗
PubMed2002

Morbidity and mortality of gastrectomy for cancer in Department of Veterans Affairs Medical Centers.

BACKGROUND: The purpose of this study was to define risk factors that predict 30-day morbidity and mortality after gastrectomy for cancer in Veterans Affairs (VA) Medical Centers. METHODS: The VA National Surgical Quality Improvement Program prospectively collected data on 708 patients undergoing gastrectomy for cancer in 123 participating VA medical centers from 1991 to 1998. Independent variables included 68 preoperative patient characteristics and 12 intraoperative variables; the dependent variables were 21 defined adverse outcomes and death. Predictive models for 30-day morbidity and mortality were constructed by using stepwise logistic regression analysis. RESULTS: The 30-day morbidity rate was 33.3% (236 of 708). The overall 30-day mortality rate was 7.6% (54 of 708). Significant positive predictors of morbidity (P <.05) included current pneumonia, American Society of Anesthesiologists class IV (threat to life), partially dependent functional status, dyspnea on minimal exertion, preoperative transfusion, extended operative time, and increasing age. Significant positive predictors of mortality (P <.05) included do not resuscitate status, prior stroke, intraoperative transfusion, preoperative weight loss, preoperative transfusion, and elevated preoperative alkaline phosphatase level. CONCLUSIONS: Risk factors predicting morbidity and mortality rates at VA hospitals after gastrectomy for gastric cancer are reported by using a prospectively collected, multi-institutional database. Assigning relative weights to factors associated with adverse outcomes may help improve patient care.

Adult↗