Hill et al identified risk factors for in-hospital mortality following a pancreatic resection. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Massachusetts Medical School and Massachusetts General Hospital.


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



• 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.


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