Pretreatment red blood cell distribution width as a predictive marker for postoperative complications after laparoscopic pancreatoduodenectomy

Table 4 Subgroup analysis of risk factors for the development of postoperative complications of grades IIIa or higher, grades IIIb or higher according to the Clavien-Dino classification, and specific types of postoperative complications, including severe bile leakage, severe postoperative pancreatic fistula, delayed gastric emptying, hemorrhage, and intra-abdominal infection in patients who underwent laparoscopic pancreatoduodenectomy

POCs	Variables	Univariate analysis		Multivariate analysis
		OR (95%CI)	P value	OR (95%CI)	P value
CDc grade IIIb or higher	ECOG score, 2 vs 0-1	3.415 (1.659-7.028)	0.001	4.169 (1.895-9.174)	< 0.001
	Preoperative biliary drainage, yes vs no	0.225 (0.054-0.940)	0.041	0.138 (0.032-0.600)	0.008
	Smoking, yes vs no	1.735 (0.970-3.101)	0.063	1.496 (0.727-3.079)	0.274
	Drinking, yes vs no	1.712 (0.952-3.078)	0.072	1.650 (0.791-3.440)	0.182
	ALP, ≥ 140 U/L vs < 140 U/L	1.783 (0.896-3.546)	0.099	1.614 (0.717-3.634)	0.247
	RDW, ≥ 15.4 vs < 15.4	2.326 (1.298-4.169)	0.005	2.127 (1.116-4.055)	0.022
	Lymphocyte, ≥ 3.2 × 109/L vs < 3.2 × 109/L	6.383 (1.206-33.775)	0.029	6.536 (1.068-39.978)	0.042
	CRP, ≥ 10 mg/L vs < 10 mg/L	1.836 (1.020-3.302)	0.043	1.400 (0.741-2.646)	0.300
Severe POPF (grade B and C)	Age, ≥ 65 years vs < 65 years	1.756 (1.113-2.772)	0.016	1.435 (0.889-2.316)	0.139
	ECOG score, 2 vs 0-1	2.671 (1.433-4.981)	0.002	2.878 (1.435-5.774)	0.003
	Operative time	0.997 (0.994-1.000)	0.026	0.996 (0.993-0.999)	0.006
	RDW, ≥ 15.4 vs < 15.4	2.442 (1.539-3.875)	< 0.001	2.246 (1.320-3.820)	0.003
	Hemoglobin, ≥ 115 g/L vs < 115 g/L	0.544 (0.335-0.882)	0.014	0.856 (0.495-1.481)	0.579
	Leucocytes, ≥ 9.5 × 109/L vs < 9.5 × 109/L	1.755 (0.924-3.334)	0.086	1.609 (0.815-3.177)	0.170
	Albumin, < 35 g/L vs ≥ 35 g/L	1.885 (1.130-3.143)	0.015	1.153 (0.641-2.074)	0.643
	PT, ≥ 14 seconds vs < 14 seconds	0.343 (0.106-1.115)	0.075	0.229 (0.067-0.783)	0.019
Severe BL	Diabetes mellitus, yes vs no	3.110 (1.408-6.870)	0.005	2.484 (1.105-5.583)	0.028
	Smoking, yes vs no	2.010 (1.289-3.133)	0.002	1.660 (0.959-2.874)	0.070
	Drinking, yes vs no	1.580 (1.005-2.484)	0.048	1.200 (0.687-2.097)	0.522
	BMI ≥ 24 kg/m2 vs < 24 kg/m2	2.442 (1.439-4.143)	0.001	1.988 (1.143-3.456)	0.015
	Intra-operative blood transfusion, yes vs no	1.660 (1.050-2.625)	0.030	1.210 (0.707-2.072)	0.487
	RDW, ≥ 15.4 vs < 15.4	3.587 (2.287-5.628)	< 0.001	3.401 (1.979-5.845)	< 0.001
	Hemoglobin, ≥ 115 g/L vs < 115 g/L	0.648 (0.401-1.048)	0.077	0.824 (0.448-1.515)	0.533
	TBIL, ≥ 235 μmol/L vs < 235 μmol/L	2.188 (1.402-3.417)	0.001	1.326 (0.776-2.264)	0.302
	Albumin, < 35 g/L vs ≥ 35 g/L	2.326 (1.434-3.774)	0.001	1.290 (0.721-2.309)	0.391
	CRP, ≥ 10 mg/L vs < 10 mg/L	1.527 (0.967-2.413)	0.069	1.138 (0.679-1.907)	0.623
Severe hemorrhage	ECOG score, 2 vs 0-1	2.715 (1.455-5.066)	0.002	2.832 (1.447-5.540)	0.002
	Smoking, yes vs no	1.937 (1.223-3.068)	0.005	1.437 (0.820-2.517)	0.206
	Drinking, yes vs no	2.064 (1.299-3.278)	0.002	1.858 (1.047-3.297)	0.034
	RDW, ≥ 15.4 vs < 15.4	1.998 (1.252-3.189)	0.004	1.794 (1.050-3.063)	0.032
	GGT, ≥ 45 U/L vs < 45 U/L	1.735 (0.969-3.108)	0.064	1.215 (0.640-2.307)	0.551
	Albumin, < 35 g/L vs ≥ 35 g/L	1.792 (1.067-3.008)	0.027	1.022 (0.559-1.869)	0.944
	CRP, ≥ 10 mg/L vs < 10 mg/L	1.582 (0.986-2.536)	0.057	1.181 (0.699-1.997)	0.534
Intra-abdominal infection	Age, ≥ 65 vs < 65	1.539 (1.067-2.220)	0.021	1.363 (0.928-2.001)	0.114
	ECOG score, 2 vs 0-1	1.887 (1.076-3.310)	0.027	1.725 (0.957-3.109)	0.070
	Hypertension, yes vs no	1.577 (1.069-2.326)	0.022	1.365 (0.909-2.052)	0.134
	Drinking, yes vs no	1.603 (1.100-2.338)	0.014	1.556 (1.052-2.301)	0.027
	RDW, ≥ 15.4 vs < 15.4	1.483 (1.008-2.180)	0.045	1.201 (0.793-1.817)	0.387
	Leucocytes, ≥ 9.5 × 109/L vs < 9.5 × 109/L	1.618 (0.942-2.779)	0.081	1.247 (0.703-1.817)	0.450
	TBIL, ≥ 235 μmol/L vs < 235 μmol/L	1.426 (0.977-2.081)	0.066	1.585 (1.027-2.446)	0.038
	CRP, ≥ 10 mg/L vs < 10 mg/L	1.675 (1.147-2.448)	0.008	1.304 (0.868-1.960)	0.202
Severe DGE	Pathology, malignant tumors vs benign tumors	1.652 (0.944-2.892)	0.079	1.058 (0.548-2.042)	0.886
	Preoperative biliary drainage, yes vs no	0.365 (0.130-1.024)	0.055	0.421 (0.144-1.236)	0.155
	Pancreatitis, yes vs no	2.748 (1.354-5.578)	0.005	2.555 (1.158-5.639)	0.020
	Intra-operative blood transfusion, yes vs no	1.931 (1.137-3.279)	0.015	1.667 (0.901-3.082)	0.103
	ASA, III vs I-II	1.683 (0.935-3.031)	0.083	1.893 (1.028-3.487)	0.041
	RDW, ≥ 15.4 vs < 15.4	1.105 (0.629-1.940)	0.729	1.130 (0.573-2.226)	0.725
	Operative time	1.003 (1.000-1.005)	0.028	1.002 (0.999-1.005)	0.212
	Lymphocyte, ≥ 3.2 × 109/L vs < 3.2 × 109/L	4.913 (0.933-25.861)	0.060	4.019 (0.696-23.193)	0.120
	ALP, ≥ 140 U/L vs < 140 U/L	2.131 (1.265-3.588)	0.004	2.913 (1.538-5.518)	0.001
	Albumin, < 35 g/L vs ≥ 35 g/L	2.201 (1.251-3.871)	0.006	3.065 (1.568-5.992)	0.001
CCI ≥ 26.2	Intra-operative blood transfusion, yes vs no	1.489(1.087-2.041)	0.013	1.150 (0.816-1.621)	0.425
	Preoperative biliary drainage, yes vs no	0.695 (0.456-1.060)	0.091	0.573 (0.368-0.891)	0.014
	RDW, ≥ 15.4 vs < 15.4	1.964 (1.436-2.687)	< 0.001	1.680 (1.185-2.382)	0.004
	Leucocytes, ≥ 9.5 × 109/L vs < 9.5 × 109/L	1.854 (1.171-2.936)	0.008	1.740 (1.076-2.815)	0.024
	Albumin, < 35 g/L vs ≥ 35 g/L	1.918 (1.341-2.743)	< 0.001	1.511 (1.017-2.244)	0.041
	Platelet, ≥ 350 × 109/L vs 350 × 109/L	1.472 (0.973-2.229)	0.067	1.241 (0.798-1.930)	0.337

POCs: Postoperative complications; OR: Odds ratio; CI: Confidence interval; CDc: Clavien-Dino classification; ECOG: Eastern Cooperative Oncology Group; BMI: Body mass index; ASA: American Society of Anesthesiologists; RDW: Red blood cell distribution width; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-glutamyl transferase; TBIL: Total bilirubin; CRP: C-reactive protein; PT: Prothrombin time; POPF: Postoperative pancreatic fistula; BL: Bile leakage; DGE: Delayed gastric emptying; CCI: Comprehensive complication index.