The impact of upper gastrointestinal surgical volume on short term pancreaticoduodenectomy outcomes for pancreatic adenocarcinoma in the SEER-Medicare population.
HPB (Oxford)
; 24(6): 868-874, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-34879991
ABSTRACT
BACKGROUND:
Patients undergoing pancreaticoduodenectomy (PD) at low volume PD hospitals with high volume for other complex operations have comparable outcomes to high volume PD centers. We evaluated the impact of upper gastrointestinal operations (UGI) hospital volume on the outcomes of elderly, high risk patients undergoing PD.METHODS:
Patients >65 years old who underwent PD for pancreatic adenocarcinoma were identified from SEER-Medicare (2008-2015). Four volume cohorts were created using PD tertiles and UGI median low (1st tertile PD), mixed-low (2nd tertile PD, low UGI), mixed-high (2nd tertile PD, high UGI) and high (3rd tertile PD). Multivariable logistic and negative binomial regression assessed short-term complications.RESULTS:
In total, 2717 patients were identified with a median age of 74.5 years. Patients treated at low, mixed-low and mixed-high volume hospitals, versus high volume, had higher risk of short-term complications, including major complications (low OR 1.441, 95%CI 1.165-1.783; mixed-low OR 1.374, 95%CI 1.085-1.740; mixed-high OR 1.418, 95%CI 1.098-1.832) and 90-day mortality (low OR 2.16, 95%CI 1.454-3.209; mixed-low OR 2.068, 95%CI 1.347-3.175; mixed-high OR 1.96, 95%CI 1.245-3.086).CONCLUSION:
Patients with pancreatic adenocarcinoma who are older and more medically complex benefit from undergoing surgery at high volume PD centers, independent of the operative experience of that center.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
/
Adenocarcinoma
Tipo de estudo:
Etiology_studies
Limite:
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
HPB (Oxford)
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos