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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 | identification of the 72- kDa(MMP - 2)and 92 - kDa(MMP - 9)gelatinase type iv collar - genase in preparations of laminin and Matrigel 显示文摘 | Mackay A R Gomez D E Cottam D W | 1993 | Biotech - niques1993，15，： | 1 |
| 3 | Dynamic recrystallization of Mg and Mg-Y alloys: crystallographic texture development显示文摘 | COTTAM R ROBSONB J LORIMER G DAVIS B | 2008 | Materials Science and Engineering A2008，485，12： | 1 |
| 4 | Synthesis of 2'-deoxytubercidin, 2'-deoxyadenosine, and related 2'-deoxynucleosides via a novel direct stereospecific sodium salt glycosylation procedure 显示文摘 | Kazimierczuk Z Cottam HB Revankar GR | 1984 | J Am Chem Soc1984，106，21： | 1 |
| 5 | Coagulation and fibrinolysis in primary biliary cirrhosis compared with other liver disease and during orthotopic liver transplantation显示文摘 | Segal H Cottam S Pottter D | 1997 | Hepatology1997，25，3： | 1 |
| 6 | Fibrinolytic activity during orthotopic liver transplantation with and without aprotinin显示文摘 | Segal H Hunt BJ Cottam S | 1994 | Transplantation1994，2758，12： | 1 |
| 7 | Improved haemodynamic stability with administration of aprotinin during OLT显示文摘 | Milroy SJ Cottam S Tan KC | 1995 | Br J Anaesth1995，75，6： | 1 |
| 8 | Expression of NF - kap- paB p50 in tumor stroma limits the contro] of tumors by radiation therapy 显示文摘 | Crittenden MR Cottam B Savage T | 2012 | PLoS One2012，7，39： | 1 |
| 9 | Circulatingandintratumoralmacrophagesinpatientswithhepatocellularcarcinoma:correlationwiththerapeuticapproach显示文摘 | NEWELLP COTTAM B SAVAGET etal | 2013 | AmJSurg2013，205，5： | 1 |
| 10 | Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity 显示文摘 | Cottam D Qureshi FG Mattar SG | 2006 | Surg Endosc2006，20，6： | 1 |
| 11 | 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 |
| 12 | The effect of obesity on neutrophil Fc receptors and adhesion molecules (CD16, CD11b, CD62L)显示文摘 | Cottam DR Schaefer PA Fahmy D | 2002 | Obes Surg2002，12，2： | 1 |
| 13 | Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass显示文摘 | Eid GM Cottam DR Velcu LM | 2005 | Surg Obes and Relat Dis2005，1，2： | 1 |
| 14 | Effect of surgically-induced weight loss on leukocyte indicators of chronic inflammation in morbid obesity显示文摘 | Cottam DR Schaefer PA Shaftan GW | 2002 | Obes Surg2002，12，3： | 1 |
| 15 | Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery显示文摘 | Cottam J Richards K Hasted A | 2007 | Colorectal Dis2007，9，9： | 1 |
| 16 | Dynamic re-crystallization of Mg and Mg - Y alloys : Crystallo-graphic texture development 显示文摘 | Cottam R Robson J Lorimer G | 2008 | Materials Scienceand Engineering A2008，，485： | 1 |
| 17 | Accelerated synthesis of titanium oxidenanostructures using microfluidic chips 显示文摘 | Cottam B F Krishnadasan S Demello A J Demello J C Shaffer M | 2007 | Lab Chip2007，7，2： | 1 |
| 18 | Body growth, carcass composition , and endocrine changes in lambs chronically treated with recombinanfly derived insulin-like growth factor-1 显示文摘 | Cottam Y H Blair H T Gallaher B W | 1992 | Endocrinology1992，130，： | 1 |
| 19 | Arterial intimal hyperplasia after occlusion of the adventitial vasa vasorum in the pig 显示文摘 | Barker SG Talbert A Cottam S | 1993 | Arterioscler Thromb1993，13，1： | 1 |
| 20 | 6,6-diphenyl-6H-naphtho ( 2', 3' : 2,3 ) pyran and 4,6-diphenyl-4H-naphtho ( 2', 3' : 2, 3) pyran显示文摘 | Cottam J Livingstone R | 1965 | J Chem Soc1965，，： | 1 |
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