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Review
. 2010 Aug;12(6):380-8.
doi: 10.1111/j.1477-2574.2010.00179.x.

A review of factors predicting perioperative death and early outcome in hepatopancreaticobiliary cancer surgery

Chris D Mann  1 , Tom Palser, Chris D Briggs, Iain Cameron, Myrrdin Rees, John Buckles, David P Berry
Affiliations
Review

A review of factors predicting perioperative death and early outcome in hepatopancreaticobiliary cancer surgery

Chris D Mann et al. HPB (Oxford). 2010 Aug.

Abstract

Objectives: In the context of comparisons of surgical outcomes, risk adjustment is the retrospective adjustment of a provider's or a surgeon's results for case mix and/or hospital volume. It allows accurate, meaningful inter-provider comparison. It is therefore an essential component of any audit and quality improvement process. The aim of this study was to review the literature to identify those factors known to affect prognosis in hepatobiliary and pancreatic cancer surgery.

Methods: PubMed was used to identify studies assessing risk in patients undergoing resection surgery, rather than bypass surgery, for hepatobiliary and pancreatic cancer.

Results: In total, 63 and 68 papers, pertaining to 24 609 and 63 654 patients who underwent hepatic or pancreatic resection for malignancy, respectively, were identified. Overall, 22 generic preoperative factors predicting outcome on multivariate analysis, including demographics, blood results, preoperative biliary drainage and co-morbidities, were identified, with tumour characteristics proving disease-specific factors. Operative duration, transfusion, operative extent, vascular resection and additional intra-abdominal procedures were also found to be predictive of early outcome.

Conclusions: The development of a risk adjustment model will allow for the identification of those factors with most influence on early outcome and will thus identify potential targets for preoperative optimization and allow for the development of a multicentre risk prediction model.

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Figures

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*Not resection surgery, did not investigate specified outcome measures
None
*Not resection surgery, did not investigate specified outcome measures, not cancer surgery
See this image and copyright information in PMC

References

    1. Bristol Royal Infirmary Inquiry. Learning from Bristol: the report of the public inquiry into children's heart surgery at the Bristol Royal Infirmary. London: The Stationary Office; 2001. July.
    1. Department of Health. Standards for Better Health. London: DoH; 2004. July.
    1. Jacobson B, Mindell J, McKee M. Hospital mortality league tables. BMJ. 2003;326:777–778. - PMC - PubMed
    1. Schneider EC, Epstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care. A survey of cardiovascular specialists. N Engl J Med. 1996;335:251–256. - PubMed
    1. Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL. Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA. 2004;291:2441–2447. - PubMed

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