Risk Factors of Kinney et al for Perioperative Complications in Patients Undergoing Intra-Abdominal Surgery for Metastatic Carcinoid Tumors

 

Patients at higher risk for perioperative complications:

(1) presence of carcinoid heart disease

(2) very high urinary 5-HIAA excretion

(3) failure to receive intra-operative octreotide (a somatostatin analogue)

 

where:

• Intra-operative octreotide decreased intra-operative complications but not post-operative ones.

• The normal urinary 5-HIAA excretion was <= 6 mg/day (31.4 µmol per 24 hours).

• The conversion of urinary 5-HIAA excretion from mg per day to µmol/d is to multiply by 5.23.

• The level of urinary 5-HIAA separating risk groups was not given. Patients without complications had a mean excretion of 78 mg per 24 hours while those with complications had a mean excretion of 200 mg per 24 hours.

• For the implementation I decided (a) to express urinary 5-HIAA as multiples of the upper limit of normal range and (b) to use > 20 times as the higher risk group.