In hospital outcomes after pancreatectomies: an analysis of a national database from 1996 to 2004. J Surg Oncol 2008 Sep 01;98(3):156-60
Date
07/12/2008Pubmed ID
18618606DOI
10.1002/jso.21099Scopus ID
2-s2.0-50949114756 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
INTRODUCTION: National complication rates following pancreatectomies have not been systematically reported.
METHODS: We queried the national hospital discharge survey (NHDS) database to analyze risk factors associated with mortality and length of stay after pancreatectomies.
RESULTS: An estimated 49,346 pancreatectomies were performed from 1996 to 2004. The national mortality rate is 9% with an average length of stay 15 days (Interquartile range 10-23) while the morbidity is 35%. Size of the hospital (<300 beds) (OR 2.76 (95% CI 1.14-6.70, P = 0.02)), post-operative pulmonary edema (OR 2.80 (95% CI 1.28-6.12, P = 0.01)) and sepsis (OR 5.22 (95% CI 1.94-14.11, P = 0.001)) are associated with higher mortality. Patients in larger hospitals (>500 beds) (Rate ratio 0.87 (95% CI 0.83-0.91, P < 0.001)) had a shorter hospital stay. Temporal trends reveal a shorter hospital length of stay in 2004 (Rate ratio 0.86 (95% CI 0.78-0.94, P = 0.001)) as compared to 1996. The percentage of pancreatectomies performed at larger hospitals in 1996 (40%) and 2004 (41%) has remained constant.
CONCLUSION: The national mortality and morbidity rates after pancreaticoduodenectomy are 9% and 35%, respectively. Larger hospital size and absence of pulmonary edema and sepsis improves mortality. Larger hospitals have better outcomes although the trend for regionalization is not apparent.
Author List
Turaga K, Kaushik M, Forse RA, Sasson ARMESH terms used to index this publication - Major topics in bold
AgedComorbidity
Databases, Factual
Female
Hospital Mortality
Humans
Length of Stay
Male
Middle Aged
Pancreatectomy
Pancreatic Diseases
Pancreaticoduodenectomy
Postoperative Complications
Risk Factors
Survival Rate
Time Factors
