Patient selection: pancreatectomy
Risk factors for inpatient mortality based on multivariate analysis:
(1) male gender
(2) Asian or Native American race
(3) Medicare as payor
(4) low to moderate number of pancreatectomies performed at hospital (< 27 per year)
(5) liver failure
(6) renal failure
(7) congestive heart failure
(8) proximal pancreatectomy
(9) pancreatectomy performed for malignant neoplasm
where:
• A patient undergoing a proximal pancreatectomy is more likely to have a total pancreatectomy. A total pancreatectomy will be classified with proximal in the implementation.
• A patient undergoing surgery for a malignant tumor is more likely to have more extensive surgery.
• The major risk factors were Native American race (odds ratio 7.8) and renal failure (odds ratio 9.2).
• The cause of chronic pancreatitis did not appear to be included in the analysis.
In-hospital mortality increases as the number of risk factors increases.
