Evan S Glazer, Albert Amini, Tun Jie, Rainer WG Gruessner, Robert S Krouse, Evan S Ong
Context While perioperative mortality after pancreaticoduodenectomy is decreasing, key factors remain to be elucidated. Objective The purpose of this study was to investigate inpatient mortality after pancreaticoduodenectomy in the NationwideInpatient Sample (NIS), a representative inpatient database in the USA. Methods Patient discharge data (diagnostic andprocedure codes) and hospital characteristics were investigated for years 2009 and 2010. The inclusion criteria were aprocedure code for pancreaticoduodenectomy, elective procedure, and a pancreatic or peripancreatic cancer diagnosis. Chisquare test determined statistical significance. A logistic regression model for mortality was created from significantvariables. Results Two-thousand and 958 patients were identified with an average age of 65±12 years; 53% were male. Themean length of stay was 15±12 days with a mortality of 4% and a complication rate of 57%. Eighty-six percent of pancreaticoduodenectomy occurred in teaching hospitals. Pancreaticoduodenectomy performed in teaching hospitals in thefirst half of the academic year were associated with higher mortality than in the latter half (5.5% vs. 3.4%, P=0.005). Onlogistic regression analysis, non-surgical complications are the largest predictor of death (P
