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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 | Further assess- ment of a three-component model of occupational commitment: generalize ability and differences across occupations显示文摘 | IRVING P G COLEMAN D F COOPER C L | 1997 | J Ap- plied Psychol1997，82，3： | 1 |
| 3 | Plug in to grid computing显示文摘 | M Irving G Taylor P Hobson | | 0，，： | 1 |
| 4 | Respiration,soluble carbohydrates and en- zymes of carbohydrate metabolism in tips of harvested asparagus spears显示文摘 | IRVING D E HURST P I | 1993 | Plant Science1993，94，12： | 1 |
| 5 | Maintaining remission from ulcerative colitis 显示文摘 | Chaplin S Johnston E Irving P | 2015 | Prescriber2015，26，12： | 1 |
| 6 | Examination of the combiled effects of work values and early work experiences on organizational commitment显示文摘 | MEYER J P IRVING G P ALLEN N J | 1998 | Journal of Organizational Behavior1998，，19： | 1 |
| 7 | A three-component model of customer to service providers显示文摘 | Bansal H S Irving P G Taylor S F | 2004 | Journal of the Academy of Marketing Science2004，32，3： | 1 |
| 8 | For The Record: A Single Amino Acid Substitution Affects Substrate Specificity In Cysteine Proteinases From Fasciola Hepatica显示文摘 | Smooker P M Whisstock J C Irving J A | 2008 | Protein Sci2008，9，12： | 1 |
| 9 | Corrosion Pit Size Distribution and Fatigue Lives--a Study of the EIFS Technique for Fatigue Design in the Presence of Corrosion 显示文摘 | MEDVED J J BRETON M IRVING P E | 2006 | International Journal of Fatigue2006，26，1： | 1 |
| 10 | Novel 1,2,4-oxadiazoles as potent and selective histamine H3-receptor antagonists显示文摘 | Beswick P Irving WJG | 1996 | Bioorg Med Chem Lett1996，6，7： | 1 |
| 11 | Establishment andvalidation of a standard protocol for the detection ofminimal residual disease in B lineage childhood acutelymphoblastic leukemia by flow cytometryin a multi-center setting 显示文摘 | Irving J Jesson J Virgo P | 2009 | Haematologica2009，94，6： | 1 |
| 12 | Cloning and expression of the major secreted cathepsin B-like protein from juvenile Fasciola hepatica and analysis of immunogenicity following liver fluke infection显示文摘 | Law R H P Smooker P H Irving J A | | 0，，12： | 1 |
| 13 | Loss of heterozygosity in childhood acute lymphoblastic leukemia detected by genome-wide microarray single nucleotide polymorphism analysis显示文摘 | Irving J A Bloodworth L Bown N P | 2005 | Cancer Res2005，65，8： | 1 |
| 14 | Corrosion pit size distributions and fatigue lives-a study of the EIFS technique for fatigue design in the presence of corrosion显示文摘 | Medved J J Breton M Irving P E | 2004 | Int J Fatigue2004，26，： | 1 |
| 15 | Functional role of cell surface integrins on human trophoblast cell migration: regulation by TGF- beta, IGF-11, and IGFBP-1显示文摘 | IRVING J A LALA P K | 1995 | Exp Cell Res1995，217，： | 1 |
| 16 | Effect of resin and fibre properties on impact and compression after impact per- formance of CFRP显示文摘 | Carrie D D R Irving P E | 2002 | Composites : Part A2002，33，： | 1 |
| 17 | A Threecomponent Model of Customer Commitment to Service Providers 显示文摘 | H S Bansal P G Irving S F Taylor | 2004 | Journal of the Academy of Marketing Science2004，32，2： | 1 |
| 18 | Formation of platelet-leukocyte aggregates in inflammatory bowel disease显示文摘 | IRVING P M MACEY M G SHAH U | 2004 | Inflamm Bowel Dis2004，10，： | 1 |
| 19 | Further assessments of a three-component/nodel of occupational commitment: generalizability and differences across occupations 显示文摘 | IRVING P G COLEMAN D F COOPER C L | 1997 | Journal of applied psychology1997，82，3： | 1 |
| 20 | Fatigue crack acceleration effects during tensile underloads in 7010 and 8090 aluminium alloys显示文摘 | Zitounis V Irving P E | 2007 | International Journal of Fatigue2007，29，： | 1 |
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