BACKGROUND To study mortality and infectious complications (IC) risk relative to operative duration in a large and contemporary cohort of patients undergoing hepatectomy. METHODS A retrospective cohort study of 21,443 patients from the National Surgical Quality Improvement Program dataset of patients who underwent liver resection from 2012 to 2016. RESULTS Patients undergoing hepatectomy during the study period (N = 21,443) had a mean operative duration of 243.5 min of which 16.6% (3533) developed at least one IC. The overall 30-day mortality was 1.6%. A significant increase in mortality and IC was demonstrated from 3 h of operating time (OR: 1.99 and OR: 1.94, respectively), peaking at 8 h (OR: 7.15 and OR: 6.37, respectively). Pneumonia, sepsis/septic shock, and SSI presented high prevalence and were linked to significant mortality. After case-matching, elective hepatectomy was associated with a 4-fold increased risk of infectious complications. CONCLUSIONS Operative duration was associated with a linear increased risk of mortality and IC after hepatectomy. The most critical determinants of IC were ASA class, COPD, CHF, and type of hepatectomy.

中文翻译：

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手术时间对肝切除术后感染并发症和死亡率的影响。

背景技术在一大批当代肝切除术患者中，研究相对于手术持续时间的死亡率和传染性并发​​症（IC）风险。方法一项回顾性队列研究来自2012年至2016年国家手术质量改善计划数据集的接受肝切除术的国家手术患者。结果研究期间（N = 21443）接受肝切除术的患者平均手术时间为243.5分钟，其中16.6％（3533）开发了至少一个IC。30天的总死亡率为1.6％。从3小时的手术时间（OR：1.99和OR：1.94）证明死亡率和IC显着增加，并在8 h达到峰值（OR：7.15和OR：6.37）。肺炎，败血症/败血性休克和SSI的患病率很高，并与大量死亡率相关。病例匹配后，选择性肝切除术使感染并发症的风险增加了4倍。结论手术持续时间与肝切除术后死亡率和IC风险线性增加相关。IC的最关键决定因素是ASA类，COPD，CHF和肝切除术的类型。