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183 Incidence of adverse events in patients with gynaecological malignancies in a tertiary care centre in North India: a prospective observational study
  1. Amrita Gaurav,
  2. Smrati Sabnani,
  3. Kavita Khoiwal,
  4. Shalini Rajaram,
  5. Aparajita Jeyapal,
  6. Ayush Heda and
  7. Jaya Chaturvedi
  1. All India Institute of medical Sciences, Rishikesh, India

Abstract

Introduction/Background Comprehensive statistics on the incidence of adverse events in gynaecological malignancies in developing countries like India are insufficient. This study was done to determine the incidence of adverse events in gynaecological malignancies, both intraoperatively and postoperatively. We also studied the role of patient characteristics, performance, nutritional health status, and surgical complexity as risk factors in predicting the occurrence of adverse events in women with gynaecological malignancies.

Methodology A prospective analysis of patients with proven or suspected gynaecological malignancies attending the Gynaecology Oncology out-patient department from January 2021 to March 2022 was admitted and included in the study. Patients were evaluated for different malignancies and optimised for surgery. The incidence of adverse events was analysed intraoperatively and graded according to Common Terminological Criteria for Adverse Events Version 5.0. The patients were followed on postoperative days seven, fourteen, and thirty for any complications and adverse outcomes.

Results The pre-operative evaluation was done among 124 patients, of whom 10 lost follow-up due to the COVID pandemic. 114 patients underwent surgery, were assessed for intraoperative adverse events, and were followed on postoperative days seven, fourteen, and thirty. The most common intraoperative adverse event was haemorrhage, which led to blood transfusion among 29/114 (25.45%) patients, followed by bowel injury in 9/114 (7.89%). The most common postoperative complication was also blood transfusion 29/114 (25.45%), followed by wound infection 25/114 (21.93%). The significant independent risk factors associated with adverse events were the patient’s serum albumin and ECOG performance scores 2 and 3

Conclusion The provision of satisfactory pre-operative care and optimisation for surgery is a critical step in reducing adverse events and improving quality of life in women with gynecologic cancer. Additional research is needed to identify areas of decreased compliance with guidelines and initiatives need to be taken to improve adherence to evidence-based practises.

Disclosures None.

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