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dc.contributor.authorMurphy, Melissa M.
dc.contributor.authorKnaus, William J. II
dc.contributor.authorNg, Sing Chau
dc.contributor.authorHill, Joshua S.
dc.contributor.authorMcPhee, James T.
dc.contributor.authorShah, Shimul A.
dc.contributor.authorTseng, Jennifer F.
dc.date2022-08-11T08:10:58.000
dc.date.accessioned2022-08-23T17:27:06Z
dc.date.available2022-08-23T17:27:06Z
dc.date.issued2009-10-10
dc.date.submitted2011-06-21
dc.identifier.citationHPB (Oxford). 2009 Sep;11(6):476-82. <a href="http://dx.doi.org/10.1111/j.1477-2574.2009.00076.x">Link to article on publisher's site</a>
dc.identifier.issn1365-182X (Linking)
dc.identifier.doi10.1111/j.1477-2574.2009.00076.x
dc.identifier.pmid19816611
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49786
dc.description.abstractBACKGROUND: Total pancreatectomy (TP) is performed for various indications. Historically, morbidity and mortality have been high. Recent series reporting improved peri-operative mortality have renewed interest in TP. We performed a national review of TP including indication, patient/hospital characteristics, complications and peri-operative mortality. METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify TPs performed during 1998 to 2006. Univariate analyses were used to compare patient/hospital characteristics. Multivariable logistic regression was performed to identify predictors of in-hospital mortality. Post-operative complications/disposition were assessed. RESULTS: From 1998 to 2006, 4013 weighted patient-discharges occurred for TP. Fifty-three per cent were male; mean age 58 years. Indication: neoplastic disease 67.8%. Post-operative complications occurred in 28%. Univariate analyses: TPs increased significantly (1998, n = 384 vs. 2006 n = 494, P < 0.01). 77.1% of TPs occurred in teaching hospitals (P < 0.0001), 86.4% in hospitals performing or = 70 Adjusted odds ratio (AOR) 3.4, 95% confidence interval (CI) 1.33-8.67], select patient comorbidities and year (referent = 2004-2006; 1998-2000 AOR 2.70; 95% CI 1.41-5.14) independently predicted in-patient mortality whereas hospital surgical volume did not. DISCUSSION: TP is increasingly performed nationwide with a concomitant decrease in peri-operative mortality. Patient characteristics, rather than hospital volume, predicted increased mortality.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=19816611&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756634/pdf/hpb0011-0476.pdf
dc.subjectPancreatectomy
dc.subjectSurgery
dc.titleTotal pancreatectomy: a national study
dc.typeJournal Article
dc.source.journaltitleHPB : the official journal of the International Hepato Pancreato Biliary Association
dc.source.volume11
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/surgery_pp/60
dc.identifier.contextkey2069157
html.description.abstract<p>BACKGROUND: Total pancreatectomy (TP) is performed for various indications. Historically, morbidity and mortality have been high. Recent series reporting improved peri-operative mortality have renewed interest in TP. We performed a national review of TP including indication, patient/hospital characteristics, complications and peri-operative mortality.</p> <p>METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify TPs performed during 1998 to 2006. Univariate analyses were used to compare patient/hospital characteristics. Multivariable logistic regression was performed to identify predictors of in-hospital mortality. Post-operative complications/disposition were assessed.</p> <p>RESULTS: From 1998 to 2006, 4013 weighted patient-discharges occurred for TP. Fifty-three per cent were male; mean age 58 years. Indication: neoplastic disease 67.8%. Post-operative complications occurred in 28%. Univariate analyses: TPs increased significantly (1998, n = 384 vs. 2006 n = 494, P < 0.01). 77.1% of TPs occurred in teaching hospitals (P < 0.0001), 86.4% in hospitals performing or = 70 Adjusted odds ratio (AOR) 3.4, 95% confidence interval (CI) 1.33-8.67], select patient comorbidities and year (referent = 2004-2006; 1998-2000 AOR 2.70; 95% CI 1.41-5.14) independently predicted in-patient mortality whereas hospital surgical volume did not.</p> <p>DISCUSSION: TP is increasingly performed nationwide with a concomitant decrease in peri-operative mortality. Patient characteristics, rather than hospital volume, predicted increased mortality.</p>
dc.identifier.submissionpathsurgery_pp/60
dc.contributor.departmentDepartment of Surgery
dc.source.pages476-82


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