Failure to rescue in patients with distal pancreatectomy: a nationwide analysis of 10,632 patients
| Autor: | Thomas Perrin, Jean-Baptiste Lequeu, Alain Bernard, Olivier Facy, Catherine Quantin, Jonathan Cottenet |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Failure to rescue Multivariate analysis Hepatology business.industry Gastroenterology 030230 surgery Pancreatic surgery Surgery Low volume 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Charlson comorbidity index Medicine In patient Major complication Distal pancreatectomy business |
| Zdroj: | HPB. 23:1410-1417 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2021.02.002 |
| Popis: | Background FTR appears as a major cause of postoperative mortality (POM). Hospital volume has an impact on FTR in pancreatic surgery but no study has investigated this relationship more specifically in DP. Methods We analysed patients with DP between 2009 and 2018 through a nationwide database. FTR definition was mortality among patients who experiment major complications. The cutoff between high and low volume centers was 20 pancreatectomies per year. Results Some 10,632 patients underwent DP, 5048 (47.5%) were operated in 602 (95.4%) low volume centers and 5584 (52.5%) in 29 (4.6%) high volume centers. Overall FTR occurred in 11.2% of patients and was significantly reduced in high volume centers compared to low volume centers (10.2% vs 12.5%, p = 0.047). In multivariate analysis, surgery in a high volume center was a protective factor for POM (OR = 0.570, CI95% [0.505–0.643], p Conclusion Hospital volume has a positive impact on FTR in DP. Patients with higher risk of FTR are men, with high modified Charlson comorbidity index, malignant conditions and open procedures. |
| Databáze: | OpenAIRE |
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