Defining the post‐operative morbidity index for distal pancreatectomy
This study utilizes PMI to establish the complication burden for a distal pancreatectomy (DP).
MethodsFrom 2005–2011, nine centres contributed ACS‐NSQIP complication data for 655 DPs. Each complication was assigned an Accordion severity weight ranging from 0.11 for grade 1 to 1.00 for grade 6 (death). The PMI is the sum of complication severity weights divided by the total number of patients.
ResultsACS‐NSQIP complications occurred in 177 patients (27.0%). The non risk‐adjusted PMI for DP is 0.087. Bleeding/Transfusion and Organ Space Infection were the most common complications. Frequency and burden differed across Accordion grades. While grade 4–6 complications represented only 15.4% of complication occurrences, they accounted for 30.4% of the burden. Subgroup analysis demonstrates that the PMI did not vary based on laparoscopic versus open approach or the performance of a splenectomy.
DiscussionThis study uses two validated systems to quantitatively establish the morbidity of a DP. The PMI allows estimation of both the frequency and severity of complications and thus provides a more comprehensive assessment of risk.
Source: HPB: official journal of the International Hepato Pancreat Biliary Association - Category: Gastroenterology Authors: Major K. Lee, Russell S. Lewis, Steven M. Strasberg, Bruce L. Hall, John D. Allendorf, Joal D. Beane, Stephen W. Behrman, Mark P. Callery, John D. Christein, Jeffrey A. Drebin, Irene Epelboym, Jin He, Henry A. Pitt, Emily Winslow, Christopher Wolfgang, Ch Tags: Original Article Source Type: research