Liedman et al identified risk factors for morbidity or mortality following surgery of a gastro-esophageal carcinoma. These can help to identify a patient who may require more aggressive management in the perioperative period. The authors are from Sahlgren's Hospital and the University of Gothenburg in Sweden.


Patient selection: surgery for gastro-esophageal carcinoma


Outcomes: morbidity (pneumonia, other) and mortality


Complications were more common for thoracoabdominal resection compared to laparotomy/gastrectomy.


Risk factors for post-operative pneumonia following thoracoabdominal resection:

(1) abnormal chest X-ray prior to surgery

(2) obstructive changes on spirometry

(3) high risk predicted by the anesthesiologist.


Risk factors for mortality following thoracoabdominal resection:

(1) history of pulmonary disease

(2) working capacity during exercise testing < 80 W


If both risk factors are absent, then the outcome is good.

If both risk factors are present, then the outcome is poor.


Older patient age was also associated with mortality following thoracoabdominal resection.


To read more or access our algorithms and calculators, please log in or register.