Title :

Root-cause Analysis of Mortality After Pancreatic Resection (CARE Study) A Multicenter Cohort Study

Author(s) :

Beugniez, Cesar [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Sauvanet, Alain [Auteur]
Service d’Hépatologie [Hôpital Beaujon]
Sulpice, Laurent [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Nutrition, Métabolismes et Cancer [NuMeCan]
Gaujoux, Sebastien [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Turrini, Olivier [Auteur]
Institut Paoli-Calmettes [IPC]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Truant, Stephanie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Schwarz, Lilian [Auteur]
Service de Chirurgie Digestive [CHU Rouen]
Piessen, Guillaume [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Regimbeau, Jean Marc [Auteur]
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Chirurgie digestive [CHU Amiens]
Muscari, Fabrice [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Adham, Mustapha [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Pattou, Francois [Auteur]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Schneider, Lucil [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Clement, Guillaume [Auteur]
Delpero, Jean-Robert [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Pruvot, Francois-Rene [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
El Amrani, Mehdi [Auteur]
Miniaturisation pour la Synthèse, l’Analyse et la Protéomique - UAR 3290 [MSAP]
Grp, French-Achbt Working [Auteur]

Journal title :

Annals of Surgery

Pages :

789-796

Publisher :

Lippincott, Williams & Wilkins

Publication date :

2021-11

ISSN :

0003-4932

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objectives: Analyze a multicenter cohort of deceased patients after pancreatectomy in high-volume centers in France by performing a root-cause analysis (RCA) to define the avoidable mortality rate. Background: Despite ...
Show more >Objectives: Analyze a multicenter cohort of deceased patients after pancreatectomy in high-volume centers in France by performing a root-cause analysis (RCA) to define the avoidable mortality rate. Background: Despite undeniable progress in pancreatic surgery for over a century, postoperative outcome remains particularly worse and could be further improved. Methods: All patients undergoing pancreatectomy between January 2015 and December 2018 and died postoperatively within 90 days after were included. RCA was performed in 2 stages: the first being the exhaustive collection of data concerning each patient from preoperative to death and the second being blind analysis of files by an independent expert committee. A typical root cause of death was defined with the identification of avoidable death. Results: Among the 3195 patients operated on in 9 participating centers, 140 (4.4%) died within 90 days after surgery. After the exclusion of 39 patients, 101 patients were analyzed. The cause of death was identified in 90% of cases. After RCA, mortality was preventable in 30% of cases, mostly consequently to a preoperative assessment (disease evaluation) or a deficient postoperative management (notably pancreatic fistula and hemorrhage). An inappropriate intraoperative decision was incriminated in 10% of cases. The comparative analysis showed that young age and arterial resection, especially unplanned, were often associated with avoidable mortality. Conclusions: One-third of postoperative mortality after pancreatectomy seems to be avoidable, even if the surgery is performed in high volume centers. These data suggest that improving postoperative pancreatectomy outcome requires a multidisciplinary, rigorous, and personalized management.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017

Source :

Harvested from HAL

Submission date :

2024-02-17T04:09:21Z