Purpose: We conducted this retrospective cohort study to evaluate which preoperative comorbidities and their combinations are most strongly associated with postoperative complications after gastrectomy. Methods: We collected data on 214 consecutive patients who underwent gastrectomy for gastric cancer. Preoperative comorbidities were placed into one of ten categories: cardiac, pulmonary, liver, renal, central nervous system, hypertension, diabetes, endocrine/metabolic, vascular, and immune/hematological. The relationship between the number of comorbidities and the incidence of postoperative complications was evaluated. Results: Among 120 patients (56.1 %) with comorbidities, 48 had a single comorbidity and 72 had multiple (≥2) comorbidities. The incidence of postoperative complications was 45.8 % (33/72) for patients with multiple comorbidities and 23.9 % (34/142) for those with 0 or 1 comorbidity (P = 0.001). Among the ten types of comorbidities, only pulmonary (P = 0.019) and vascular diseases (P = 0.007) were significantly associated with the occurrence of postoperative complications. Conclusion: Patients with multiple comorbidities had a significantly higher incidence of postoperative complications after gastrectomy. Among the comorbidities studied, pulmonary and vascular diseases had the strongest association with postoperative complications.
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