Defining morbidity after pancreaticoduodenectomy: Use of a prospective complication grading system Journal Article
| Authors: | Grobmyer, S. R.; Pieracci, F. M.; Allen, P. J.; Brennan, M. F.; Jaques, D. P. |
| Article Title: | Defining morbidity after pancreaticoduodenectomy: Use of a prospective complication grading system |
| Abstract: | Background: Improving surgical quality of care requires accurate reporting of postoperative complications. Study design: Accuracy of a prospective surgical complication grading database was assessed by performing a retrospective review of 204 pancreaticoduodenectomies (PDs) entered into the database from January 1, 2001, to December 31, 2003. This updated database was then used to characterize 30-day morbidity and mortality after PD. Results: On review, 13% of patients had a complication not identified in the prospective complication database, 8% of patients had a complication reclassified, and 4% of patients had a complication removed. At least 1 postoperative complication was experienced by 47% of patients. After PD, 45 different complications occurred. Postoperative mortality at 30 days was 1%, and 30-day readmission rate was 11%. The 30-day reoperation rate was 9%, and 14% of patients required a percutaneous drainage procedure. Pancreatic anastomotic leak (12%), wound infection (11%), and delayed gastric emptying (7%) were the 3 most common postoperative complications, and all were associated with an increased length of stay. Conclusions: Our prospective surgical complication database accurately characterized outcomes after PD and facilitated information gathering and analysis. The accuracy, efficiency, and reproducibility of a prospective surgical complication database favor its widespread use in postoperative complication reporting. © 2007 American College of Surgeons. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; major clinical study; pancreatic neoplasms; outcome assessment; follow-up studies; prospective studies; pancreaticoduodenectomy; reproducibility; accuracy; morbidity; data base; retrospective study; postoperative complication; postoperative complications; length of stay; severity of illness index; reoperation; surgical mortality; rating scale; medical documentation; hospital readmission; wound infection; stomach neoplasms; biliary tract neoplasms; percutaneous drainage; anastomosis leakage; stomach emptying |
| Journal Title: | Journal of the American College of Surgeons |
| Volume: | 204 |
| Issue: | 3 |
| ISSN: | 1072-7515 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2007-03-01 |
| Start Page: | 356 |
| End Page: | 364 |
| Language: | English |
| DOI: | 10.1016/j.jamcollsurg.2006.11.017 |
| PUBMED: | 17324768 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 47" - "Export Date: 17 November 2011" - "CODEN: JACSE" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work