Pancreatectomy risk calculator: an ACS-NSQIP resource

Parikh, Purvi; Shiloach, Mira; Cohen, Mark E.; Bilimoria, Karl Y.; Ko, Clifford Y.; Hall, Bruce L.; Pitt, Henry A.

doi:10.1111/j.1477-2574.2010.00216.x

Cited by 182 publications

(138 citation statements)

References 35 publications

Supporting

Mentioning

134

Contrasting

Order By: Relevance

“…However, morbidity was still high at 41.56%, and it was not excellent compared with that reported in other institutional or national reports 2, 3, 4, 13. A PF remained the leading cause of total complications; in particular, a PF with an ISGPF grade C was associated with 76.47% of all C–D grades IV–V complications and it significantly resulted in the occurrence of a serious morbidity.…”

Section: Discussionmentioning

confidence: 66%

“…For the 17,564 patients undergoing PD recorded in the NCD, the 30‐day and in‐hospital mortality rates after PD were extremely low at 1.31% and 2.88%, respectively, which were much better than those of other national cohort‐based reports 12, 13, 14. However, morbidity was still high at 41.56%, and it was not excellent compared with that reported in other institutional or national reports 2, 3, 4, 13.…”

Section: Discussionmentioning

confidence: 84%

See 1 more Smart Citation

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Aoki

Matsubara

Konno

et al. 2017

J Hepatobiliary Pancreat Sci

128

138

View full text Add to dashboard Cite

BackgroundThe morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien–Dindo classification grades IV–V), and create complication risk calculators using the Japanese National Clinical Database.MethodsBetween 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The morbidity rate and associated risk factors were analyzed.ResultsThe overall and serious morbidity rates were 41.6% and 4.5%, respectively. A pancreatic fistula (PF) with an International Study Group of Pancreatic Fistula (ISGPF) grade C was significantly associated with serious morbidity (P < 0.001). Twenty‐one variables were considered statistically significant predictors of serious complications, and 15 of them overlapped with those of a PF with ISGPF grade C. The predictors included age, sex, obesity, functional status, smoking status, the presence of a comorbidity, non‐pancreatic cancer, combined vascular resection, and several abnormal laboratory results. C‐indices of the risk models for serious morbidity and grade C PF were 0.708 and 0.700, respectively.ConclusionsPreventing a PF grade C is important for decreasing the serious morbidity rate and these risk calculations contribute to adequate patient selection.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 84%

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Aoki

Matsubara

Konno

et al. 2017

J Hepatobiliary Pancreat Sci

128

138

View full text Add to dashboard Cite

show abstract

“…Most previous outcome studies have grouped patients' diagnoses by benign and malignant disease categories; [17][18][19] this categorization scheme may not be the best method to assess risk and predict outcomes because it does not consider gland size or texture. A recent study from our institution has shown that stratifying patients by diagnosis (and, thus, gland size and texture) can predict risk for postoperative complications in patients of all ages presenting for PD.…”

Section: Introductionmentioning

confidence: 99%

Risk by indication for pancreaticoduodenectomy in patients 80 years and older: a study from the American College of Surgeons National Surgical Quality Improvement Program

Bergquist¹,

Shubert²,

Ubl³

et al. 2016

HPB

View full text Add to dashboard Cite

Background: Expected mortality after elective pancreaticoduodenectomy (PD) in contemporary series is less than 5% in elderly patients; however, to our knowledge, mortality rate has not been correlated with indication for PD. We hypothesized that perioperative risk following PD would correlate with diagnostic indication in older patients. Methods:The American College of Surgeons NSQIP database was reviewed to identify patients (<80 and 80 years) who underwent PD from January 1, 2005, through December 31, 2012. High-and low-risk diagnoses were determined by using 30-day, major-morbidity data. Univariate and multivariable analyses were used to compare outcomes.Results: Pancreatic cancer and chronic pancreatitis were found to be low-risk diagnoses in elderly patients, whereas bile duct and ampullary neoplasm, duodenal neoplasm, and neuroendocrine tumors were high-risk diagnoses. The risk of 30-day mortality for older patients (80 y) undergoing PD was 6.1% for those with high-risk diagnoses vs 4.5% for those with low-risk diagnoses (P = .27). On multivariable analysis (controlling for confounders), a high-risk diagnosis was shown to be an independent predictor of prolonged length of stay, superficial surgical-site infection (SSI), and organ-space SSI. There was no increased risk of complications in patients 80 years with low-risk diagnoses. Conclusion:In patients 80 or older undergoing PD, perioperative risk varies by diagnostic indication.Patients should receive preoperative counseling about their risk.

show abstract

“…Approximately one‐third of pancreatectomy volumes in the USA comprises patients who have distal pancreatectomy rather than pancreaticoduodenectomy, and these patients have a significantly lower risk of morbidity and mortality38. The present analysis was limited to patients with highest expected perioperative mortality rate, including only patients with complex HPB resections and total gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Effects of patient factors on inpatient mortality after complex liver, pancreatic and gastric resections

Zaydfudim

Stukenborg

2017

BJS Open

View full text Add to dashboard Cite

BackgroundThere is mixed evidence that patients who receive care in hospitals with a low case volume for complex gastrointestinal and hepatobiliary operations have an increased risk of inpatient death.MethodsA retrospective cohort study was performed of patients who had complex gastrointestinal and hepatobiliary operations in the Healthcare Cost and Utilization Project 2012 National Inpatient Sample. Multivariable weighted hierarchical generalized linear models were used to test the relationship between hospital case volume and probability of inpatient death, with detailed adjustments for the concurrent effects of differences in associated patient co‐morbidities.ResultsA total of 8260 pancreaticoduodenectomies, 2750 major hepatectomies and 3250 total gastrectomies were identified. Inpatient death occurred in 3·6 per cent of patients after pancreaticoduodenectomy, 4·9 per cent after major hepatectomy and 4·6 per cent after total gastrectomy. Mean hospital case volume was 50·6 (median 40) for pancreaticoduodenectomy, 23·6 (median 15) for major hepatectomy, 15·1 (median 10) for total gastrectomy and 70·2 (median 50) for any of the three operations. Hospital case volume was not a statistically significant predictor of mortality after any operation (all P ≥ 0·188). Patient characteristics including age and co‐morbidity were highly significant predictors of mortality (P < 0·001). No significant improvements in model performance were obtained by adding hospital case volume to any model that already included adjustments for patient‐level differences in age and co‐morbid disease, for any functional format (P ≥ 0·146 for all C statistic differences from baseline).ConclusionPatient co‐morbidity, not hospital case volume, was associated with significant differences in inpatient mortality following complex gastric, pancreatic and hepatobiliary resections.

show abstract

Pancreatectomy risk calculator: an ACS-NSQIP resource

Cited by 182 publications

References 35 publications

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Risk by indication for pancreaticoduodenectomy in patients 80 years and older: a study from the American College of Surgeons National Surgical Quality Improvement Program

Effects of patient factors on inpatient mortality after complex liver, pancreatic and gastric resections

Contact Info

Product

Resources

About