Title :

Is Centralization Needed for Patients Undergoing Distal Pancreatectomy?

Author(s) :

Roussel, Edouard [Auteur]
Hôpital Charles Nicolle [Rouen]
Clément, Guillaume [Auteur]
Centre de recherche sur les Ions, les MAtériaux et la Photonique [CIMAP - UMR 6252]
Lenne, Xavier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Pruvot, François-René [Auteur]
Hôpital Claude Huriez [Lille]
Schwarz, Lilian [Auteur]
Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques [GPMCND]
Service de Chirurgie Digestive [CHU Rouen]
Theis, Didier [Auteur]
Université Lille Nord (France)
Truant, Stéphanie [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
El Amrani, Mehdi [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]

Journal title :

Pancreas

Pages :

1188-1194

Publication date :

2019-10-08

ISSN :

0885-3177

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective The centralization of complex surgical procedures is associated with better postoperative outcomes. However, little is known about the impact of hospital volume on the outcome after distal pancreatectomy. Methods ...
Show more >Objective The centralization of complex surgical procedures is associated with better postoperative outcomes. However, little is known about the impact of hospital volume on the outcome after distal pancreatectomy. Methods Using the French national hospital discharge database, we identified all patients having undergone distal pancreatectomy in France between 2012 and 2015. A spline model was applied to determine the caseload cut-off in annual distal pancreatectomy that influenced 90-day postoperative mortality. Results A total of 3314 patients were identified. Use of a spline model did not reveal a cut-off in the annual distal pancreatectomy caseload. By taking the median number of distal pancreatectomy (n = 5) and the third quartile (n = 15), we stratified centers into low, intermediate, and high hospital volume groups. The overall postoperative mortality rate was 3.0% and did not differ significantly between these groups. In a multivariable analysis, age, Charlson comorbidity score, septic complications, hemorrhage, shock, and reoperation were independently associated with a greater overall risk of death. However, hospital volume had no impact on mortality after distal pancreatectomy (odds ratio, 0.954; 95% confidence interval, 0.552–1.651, P = 0.867). Conclusions Hospital volume does not seem to influence mortality after distal pancreatectomy in France, and centralization may not necessarily improve outcomes.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL