Clavien-Dindo classification and risk factors of gastrectomy-related complications: an analysis of 1049 patients.

Objective: The objective of the present study was to explore the major risk factors of surgical complications using the Clavien-Dindo classification.

Methods: The case-control design was used. A total of 1049 patients who underwent radical gastrectomy in Hunan Cancer Hospital between October 2010 and August 2014 were retrospectively analyzed, including 122 patients (11.6%) with complications and 927 patients (88.4%) with no complications. Risk factors were evaluated.

Results: Following radical gastrectomy, 122 patients (11.6%) experienced a total of 151 complications. The incidence of Stages II, IIIa, IIIb, IVa, IVb and V complications was 9.6% (n = 101), 2.5% (n = 26), 1.0% (n = 11), 0.8% (n = 8), 0% (n = 0), and 0.5% (n = 5), respectively. The incidence of severe complications (Stage ≥ IIIa) was 4.8% (n = 50). Multivariate analysis showed that combined resection (Odds Ratio [OR] = 3.36, 95% confidence interval [CI]: 1.71~6.60, P < 0.01), perioperative blood transfusion (OR = 2.13, 95% CI: 1.38-3.29, P < 0.01), and BMI ≥ 25 kg/m(2) (OR = 1.98, 95% CI: 1.16-3.40, P = 0.01) were independent risk factors of complications.

Conclusions: Combined resection, perioperative blood transfusion, and BMI ≥ 25 kg/m(2) are positively correlated with complications.