In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 24, No. 18_suppl ( 2006-06-20), p. 4035-4035
Abstract:
4035 Background: Pancreatic resection remains the only potentially curative intervention for pancreatic cancer. The goal of this study was to evaluate factors affecting outcomes after pancreatectomy for neoplasm using a large national database. Methods: This is a retrospective analysis of 6,091patients (pts) undergoing pancreatic resection for non-endocrine neoplastic disease obtained from the National Inpatient Sample 1998–2003 (≈ 30,241 pts nationally by weighted analysis). Crude primary outcome measures of in-hospital mortality and postoperative disposition were analyzed by chi-square. A proportional hazards model was then constructed to adjust outcomes for age, sex, hospital teaching status, hospital surgical volume and selected co-morbid conditions. Results: 42,380 patient discharges (≈209,016 nationally) occurred with a primary diagnosis of pancreatic neoplasm. 6,091 (14%) pts underwent resection during that hospitalization. In-hospital mortality was 5.8% with a significant decrease of 7.7% - 4.4% from 1998–2003 (p=.016, regression coefficient .0042). In the univariate analysis pts treated at a non-teaching hospital had higher mortality rates (9.4% vs. 4.4% p 〈 .0001). However, when adjusted for covariates including hospital surgical volume [low ( 〈 4 resections/year), medium (4–13/year), high ( 〉 13/year)] teaching status became insignificant in predicting mortality. Resections done at low and medium volume centers were predictive of higher mortality compared to high volume centers (OR 4.1 [2.7, 6.1] and OR 2.4 [1.6, 3.6]). Female gender was predictive of lower mortality (OR 0.58 [0.46, 0.74] ). Younger pts (40–69) had lower mortality than pts 70 years or older. Overall, median post-operative length of stay (LOS) was 11 days (SD 23.9). LOS was shorter for female patients (median 10 days vs. ll days) and for resections done at high volume centers (median 10 days vs. ll days). Conclusions: This large observational study demonstrates an improvement in operative mortality for patients undergoing pancreatectomy for neoplastic disease 1998–2003. Furthermore, it demonstrates superior adjusted outcomes in terms of mortality, and LOS, for females, younger patients, and those treated at high volume surgical centers in the United States. No significant financial relationships to disclose.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2006.24.18_suppl.4035
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2006
detail.hit.zdb_id:
2005181-5
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