Pancreatectomy risk calculator: An ACS-NSQIP resource

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

Research output: Contribution to journalArticle

Abstract

Background: The morbidity of pancreatoduodenectomy remains high and the mortality may be significantly increased in high-risk patients. However, a method to predict post-operative adverse outcomes based on readily available clinical data has not been available. Therefore, the objective was to create a 'Pancreatectomy Risk Calculator' using the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database. Methods: The 2005-2008 ACS-NSQIP data on 7571 patients undergoing proximal (n = 4621), distal (n = 2552) or total pancreatectomy (n = 177) as well as enucleation (n = 221) were analysed. Pre-operative variables (n = 31) were assessed for prediction of post-operative mortality, serious morbidity and overall morbidity using a logistic regression model. Statistically significant variables were ranked and weighted to create a common set of predictors for risk models for all three outcomes. Results: Twenty pre-operative variables were statistically significant predictors of post-operative mortality (2.5%), serious morbidity (21%) or overall morbidity (32%). Ten out of 20 significant pre-operative variables were employed to produce the three mortality and morbidity risk models. The risk factors included age, gender, obesity, sepsis, functional status, American Society of Anesthesiologists (ASA) class, coronary heart disease, dyspnoea, bleeding disorder and extent of surgery. Conclusion: The ACS-NSQIP 'Pancreatectomy Risk Calculator' employs 10 easily assessable clinical parameters to assist patients and surgeons in making an informed decision regarding the risks and benefits of undergoing pancreatic resection. A risk calculator based on this prototype will become available in the future as on online ACS-NSQIP resource.

Original languageEnglish (US)
Pages (from-to)488-497
Number of pages10
JournalHPB
Volume12
Issue number7
DOIs
StatePublished - Sep 2010

Keywords

  • ACS-NSQIP
  • Pancreatectomy
  • Pancreatic resections
  • Risk calculator

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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