Slow Gait Speed Is a Risk Factor for Complications After Hepatic Resection
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The aims of this study were to clarify the relationship of gait speed, hand grip strength, and skeletal muscle mass with complications after hepatic resection and to identify risk factors for complications in patients who underwent hepatic resection.
We evaluated the risk factors for complications after hepatic resection in 154 consecutive patients. Preoperative factors included gait speed, hand grip strength, and skeletal muscle mass. The gait speed and hand grip strength of patients were measured by physical therapists, and skeletal muscle mass was measured by computed tomography. Multivariate logistic regression analyses using preoperative factors were performed to assess predictors of the development of complications after hepatic resection.
Thirty-three patients (21.4%) developed complications after hepatic resection. These patients had a significantly lower serum albumin level (p = 0.015), slower gait speed (p = 0.007), higher rate of hepatic resection ≥ 2 Couinaud segments (p = 0.014), and lower rate of laparoscopic hepatic resection (p = 0.017) than patients without complications. Multivariate analysis revealed that a gait speed ≤ 1.10 m/s and a serum albumin level of ≤ 4.0 g/dl were independent risk factors for complications after hepatic resection.
Slow gait speed and low serum albumin level are significant risk factors for complications after hepatic resection. These data will be helpful for perioperative patient management.
KeywordsGait speed Complication Hepatic resection Frailty
We thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
S.I. participated in study conception and design, analysis, and drafting of the article.
T.Y. participated in study conception and design, and critical revision of the manuscript.
K.S. participated in acquisition of data, analysis, and interpretation of data.
T.M. participated in acquisition of data, analysis, and interpretation of data.
Y.M. participated in acquisition of data, analysis, and interpretation of data.
T.T. participated in acquisition of data, analysis, and interpretation of data.
N.H. participated in acquisition of data, analysis, and interpretation of data.
N. Harada participated in acquisition of data, analysis, and interpretation of data.
T.I. participated in acquisition of data, analysis, and interpretation of data.
Y.S. participated in acquisition of data, analysis, and interpretation of data.
R.K. participated in acquisition of data, analysis, and interpretation of data.
T.K. participated in acquisition of data, analysis, and interpretation of data.
A.N. participated in acquisition of data, analysis, and interpretation of data.
Y. Maehara participated in critical revision of the manuscript.
- 2.Itoh S, Morita K, Ueda S, Sugimachi K, Yamashita Y, Gion T, Fukuzawa K, Wakasugi K, Taketomi A, Maehara Y. Long-term Results of Hepatic Resection Combined with Intraoperative Local Ablation Therapy for Patients with Multinodular Hepatocellular Carcinomas. Ann Surg Oncol 2009;16:3299–3307.CrossRefGoogle Scholar
- 3.Doussot A, Gonen M, Wiggers JK, Groot-Koerkamp B, DeMatteo RP, Fuks D, Allen PJ, Farges O, Kingham TP, Regimbeau JM, D’Angelica MI, Azoulay D, Jarnagin WR. Recurrence Patterns and Disease-Free Survival after Resection of Intrahepatic Cholangiocarcinoma: Preoperative and Postoperative Prognostic Models. J Am Coll Surg 2016;223:493–505.CrossRefGoogle Scholar
- 13.Afilalo J, Eisenberg MJ, Morin JF, Bergman H, Monette J, Noiseux N, Perrault LP, Alexander KP, Langlois Y, Dendukuri N, Chamoun P, Kasparian G, Robichaud S, Gharacholou SM, Boivin JF. Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. J Am Coll Cardiol 2010;56:1668–1676.CrossRefGoogle Scholar
- 14.Robinson TN, Wu DS, Sauaia A, Dunn CL, Stevens-Lapsley JE, Moss M, Stiegmann GV, Gajdos C, Cleveland JC Jr, Inouye SK. Slower walking speed forecasts increased postoperative morbidity and 1-year mortality across surgical specialties. Ann Surg 2013;258:582–588; discussion 588–590.PubMedPubMedCentralGoogle Scholar
- 19.Yamashita Y, Ikeda T, Kurihara T, Yoshida Y, Takeishi K, Itoh S, Harimoto N, Kawanaka H, Shirabe K, Maehara Y. Long-term favorable surgical results of laparoscopic hepatic resection for hepatocellular carcinoma in patients with cirrhosis: a single-center experience over a 10-year period. J Am Coll Surg 2014;219:1117–1123.CrossRefGoogle Scholar
- 20.Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187–196.CrossRefGoogle Scholar
- 22.Okuda Y, Taura K, Yoshino K, Ikeno Y, Nishio T, Yamamoto G, Tanabe K, Koyama Y, Hatano E, Tanaka S, Uemoto S. Usefulness of Mac-2 Binding Protein Glycosylation Isomer for Prediction of Posthepatectomy Liver Failure in Patients With Hepatocellular Carcinoma. Ann Surg 2017;265:1201–1208.CrossRefGoogle Scholar
- 23.Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000;55:M221–M231.CrossRefGoogle Scholar
- 25.Alfredsson J, Stebbins A, Brennan JM, Matsouaka R, Afilalo J, Peterson ED, Vemulapalli S, Rumsfeld JS, Shahian D, Mack MJ, Alexander KP. Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement: Results From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Circulation 2016;133:1351–1359.CrossRefGoogle Scholar