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ABSTRACT: Objective
To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality.Background
The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated.Methods
We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 to December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days after surgery were calculated.Results
Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 and 118 days optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death.Conclusions and relevance
The 99- and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality.
SUBMITTER: Mise Y
PROVIDER: S-EPMC4633391 | biostudies-literature | 2015 Dec
REPOSITORIES: biostudies-literature
Mise Yoshihiro Y Vauthey Jean-Nicolas JN Zimmitti Giuseppe G Parker Nathan H NH Conrad Claudius C Aloia Thomas A TA Lee Jeffrey E JE Fleming Jason B JB Katz Matthew Harold G MH
Annals of surgery 20151201 6
<h4>Objective</h4>To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality.<h4>Background</h4>The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated.<h4>Methods</h4>We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) an ...[more]