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%) diseaserelated 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 overallmortality 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.
Original language | English (US) |
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Pages (from-to) | 1071-1078 |
Number of pages | 8 |
Journal | Annals of surgery |
Volume | 262 |
Issue number | 6 |
DOIs | |
State | Published - 2015 |
Keywords
- Hepatectomy
- Mortality
- Pancreatectomy
- Postoperative complications
- Root-cause analysis
ASJC Scopus subject areas
- Surgery