We have located links that may give you full text access.
Achieving an optimal textbook outcome following pancreatic resection: The impact of surgeon specific experience in achieving high quality outcomes.
American Journal of Surgery 2022 November 25
BACKGROUND: The interplay of patient-, procedural, and provider-level factors on the ability to achieve a textbook outcome(TO) remain poorly defined.
METHODS: The Medicare Standard Analytical Files from 2013 to 2017 were used to identify beneficiaries who underwent pancreatic surgery. Multivariable logistic regression with mixed effects was used to examine the role of the individual surgeon relative to patient- and procedural-factors to achieve a TO.
RESULTS: Among 20,902 patients who underwent pancreatic resection, median age was 72 years (IQR:68-77); roughly one-half of the cohort was female(47,4%) and the majority was White (89.3%). After controlling for patient- and procedure-related characteristics, there was 35% variation in odds of experiencing a TO relative to the specific individual surgeon who performed the operation (OR:1.35, 95%CI:1.29-1.41). Patients who underwent pancreatectomy by a bottom TO quartile surgeon had a higher observed/expected ratio for each component of TO including post-operative complication (OR:2.62, 95%CI:2.11-3.25), prolonged LOS (OR:3.36, 95%CI:2.67-4.22), 90-day readmission (OR:2.08, 95%CI:1.68-2.56), and 90-day mortality (OR:3.29, 95% CI:2.35-4.63) compared with patients treated by a high TO quartile surgeon.
CONCLUSION: The likelihood of achieving a TO after pancreatic resection was markedly influenced by the individual treating surgeon even after controlling for patient- and procedure-level factors.
METHODS: The Medicare Standard Analytical Files from 2013 to 2017 were used to identify beneficiaries who underwent pancreatic surgery. Multivariable logistic regression with mixed effects was used to examine the role of the individual surgeon relative to patient- and procedural-factors to achieve a TO.
RESULTS: Among 20,902 patients who underwent pancreatic resection, median age was 72 years (IQR:68-77); roughly one-half of the cohort was female(47,4%) and the majority was White (89.3%). After controlling for patient- and procedure-related characteristics, there was 35% variation in odds of experiencing a TO relative to the specific individual surgeon who performed the operation (OR:1.35, 95%CI:1.29-1.41). Patients who underwent pancreatectomy by a bottom TO quartile surgeon had a higher observed/expected ratio for each component of TO including post-operative complication (OR:2.62, 95%CI:2.11-3.25), prolonged LOS (OR:3.36, 95%CI:2.67-4.22), 90-day readmission (OR:2.08, 95%CI:1.68-2.56), and 90-day mortality (OR:3.29, 95% CI:2.35-4.63) compared with patients treated by a high TO quartile surgeon.
CONCLUSION: The likelihood of achieving a TO after pancreatic resection was markedly influenced by the individual treating surgeon even after controlling for patient- and procedure-level factors.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app