Maarten van Egmond

27 Preoperative functional status and postoperative complications 2 RESULTS We analyzed data from 94 patients between March 2012 and October 2014 with an indication for esophagectomy. We measured functional status of 92 patients one day before surgery. We missed 2 patients for measurements on preoperative functional status. None of the patients showed severe cognitive, functional or nutritional impairments. During the surgical procedure, resection of the esophagus was not possible in 4 patients and they were subsequently left out in the final analysis. Table 1 presents patient- and surgical characteristics of 94 patients. Mean age (SD) was 63.8 years (9.4) and 74 patients were male. Pulmonary function was better than predicted (100%) with a forced vital capacity (FVC) of (mean percentage, [SD]) 113.1 [16.0], forced expiratory volume in 1 second (FEV1) of 106.6 [17.5] and inspiratory vital capacity (IVC) of 109.7 [15.3] respectively. The measurements presented in Table 2 show that both IMS and HGS were higher than predicted. HRQL (mean percentage, [SD]) was 83.3 [16.7] on a scale from 0 to 100 with higher scores indicating a better HRQL. All patients underwent surgery, where 77 patients were operated via a minimally invasive approach (Table 1). Figure 1 shows that 55 patients developed a POC (61.1%). Twenty-six patients suffered from a grade 3a complication or worse according to the Clavien-Dindo Classification for surgical complications and 4 died shortly after surgery. Twenty-eight out of 55 patients with POC developed more than one complication. Table 3 presents the characteristics of POC and it illustrates 19.1% pulmonary complications, 17.0 % cardiac complications and 32.2% gastrointestinal complications. Univariate analysis of both conventional factors and indicators of functional status revealed that ASA-classification II versus I (OR 0.43, 95% CI 0.14 to 1.29; P = .132), smoking (OR 2.88, 95% CI 0.94 to 8.79; P = .064) and physical activities (OR 1.00, 95 % CI 1.00 to 1.01; P = .162) were significant predictors for POC with a P -value ≤ .200 (Table 4). However, after backward elimination none of them remained significant. We compared the group of patients suffering from POC with the group of patients without POC on aspects of preoperative functional status and found no significant difference ( P ≤ .050) between these groups on all aspects of preoperative functional status. The OR of POC in the group with open surgery versus minimally invasive surgery was 0.69 (95% CI 0.21 to 2.24; P = 0.533).