Wright et al identified predictors of complications following esophagectomy for esophageal cancer. These can help to identify a patient who may benefit from more aggressive management. The authors are from Massachusetts General Hospital, University of Pennsylvania, Duke University and the Mayo Clinic.

Patient selection: esophagectomy for esophageal cancer


Major morbidities may include: deep vein thrombosis with or without pulmonary embolus, tracheostomy, atrial fibrillation, acute myocardial infarction, blood transfusion, renal failure, sepsis, chylothorax, recurrent laryngeal nerve paralysis


Predictors of complications with odds ratios >= 2:

(1) COPD/FEV1 < 60% of predicted

(2) congestive heart failure

(3) ASA status >= 3


Predictors of complications with odds ratios < 2:

(1) age >= 75 years

(2) Black race

(3) coronary artery disease

(4) peripheral vascular disease

(5) hypertension

(6) insulin-dependent diabetes

(7) cigarette smoker

(8) steroid use

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