Outcome after pancreaticoduodenectomy for XXXX : an analysis from the Veterans Affairs National Surgical Quality Improvement Program.

@entity1 @entity648 @entity204 @entity5
The aim of this study is to define the risk factors that predict adverse outcomes for @entity1 undergoing pancreaticoduodenectomy for @entity5 in the Department of Veterans Affairs Healthcare System (VA). The VA National Surgical Quality Improvement Program prospectively collected data on 462 @entity1 undergoing pancreaticoduodenectomy in 123 VA medical centers from 1990 to 2000. Independent variables included 68 preoperative and 12 intraoperative variables. The main outcome measures were 30-day postoperative mortality and morbidity, as measured by a set of 20 pre-defined complications. Predictive models for 30-day morbidity and mortality were constructed using logistic regression analysis. The 30-day morbidity rate was 45.9% (212/462). The 30-day postoperative mortality rate was 9.3% (43/462). Significant predictors of mortality included: preoperative serum albumin, American Society of Anesthesiologists classification, preoperative @entity648 >20mg/dl, and operative time. The use of preoperative biliary tract instrumentation did not predict @entity204 or septic complications. This study provides a set of preoperative risk factors that are predictive of adverse outcome following pancreaticoduodenectomy. These factors may assist in @entity1 selection for this procedure and are likely to facilitate risk-adjusted comparison of pancreaticoduodenectomy outcomes between different health care systems.
