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Title: | Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries | Authors: | Fusai, Giuseppe Kito Ferrone, Cristina Raptis, Dimitri Aristotle Abu Hilal, Mohamed Bassi, Claudio Besselink, Marc Conlon, Kevin Davidson, Brian Del Chiaro, Marco Dervenis, Christos Frigerio, Isabella Falconi, Massimo Hackert, Thilo Harrison, Ewen M. Shrikhande, Shailesh, V Siriwardena, Ajith Smith, Martin Wolfgang, Christopher Borakati, Aditya Balci, Deniz Elhadi, Muhammed Salinas, Camila Hidalgo Machairas, Nikolaos Marchegiani, Giovanni Oba, Atsushi Oberkofler, Christian Passas, Ioannis Ravikumar, Reena Sanchez Velazquez, Patricia de Santibanes, Martin Schnitzbauer, Andreas Anton Soggiu, Fiammetta Tamburrino, Domenico Tinguely, Pascale Wei, Alice Zachiotis, Marinos Bentabak, Kamel Kacimi, Salah Eddine Nikfarjam, Mehrdad Shcherba, Aliaksei SERGEANT, Gregory Coelho, Gustavo Torres, Orlando Belev, Nikolay Fabrice, Burundi Tang, Ephraim Martin, Janet Diaz, Christian Devaud, Nicolas Wei, Kongyuan Hendi, Maher Mikulic, Danko Gouvas, Nikolaos Christophides, Thalis Nikov, Andrej Fathallah, Dalia Saad , Mahmoud Tammik, Olav Huhta, Heikki Sulpice, Laurent Lupinacci, Renato Demetrashvili, Zaza Stavrou, Gregor A. Felekouras, Evangelos Papaziogas, Vasileios Misra, Sanjeev Diponegoro, Erik Prabowo Hashim, Hashim Talib Al-Sader, Maytham Al-Juaifari Satoi, Sohei Obeidat, Khaled Mohsen, Maram Fakhradiyev, Ildar Han , Ho-Seong Khalife, Mohamad Dulskas, Audrius Bong, Jin Ghani, Shahi Eduardo Padilla, Alejandro Melchor-Ruan, Javier Erdene, Sarnai Benkabbou, Amine Nashidengo, Pueya Koea, Jonathan Adeyeye, Ademola Alatise, Olusegun Ullah, Sami Abu Jayyab, Mustafa Amro, Sarah Alnammourah, Walaa Mohammed The, Catherine Pedziwiatr, Michal Polkowski, Wojciech Barbu, Sorin Traian Karamarkovic, Aleksandar Galun, Daniel Goh, Brian K. P. Trotovsek, Blaz Omoshoro-Jones, Jones Ielpo, Benedetto Abdelmageed, Abdelfatah Sandstrom, Per Cristaudi, Alessandra Gloor, Beat Kuemmerli, Christoph Tishreen, Alaa Hamdan Chaaban, Mohammad Karam Wu, Chien Hui Jen, Po-Chih Yang Fu Houssem, Ammar Baraket, Oussama Coker, Ahmet Taylor, Mark Jamieson, Nigel Iype, Satheesh Giorgakis, Emmanouil Qadan, Motaz Ganai, Sabha Al-Naggar, Hamza Chihaka, Onesai |
Issue Date: | 2023 | Publisher: | OXFORD UNIV PRESS | Source: | British Journal of Surgery, | Status: | Early view | Abstract: | Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761). | Notes: | Fusai, GK; Raptis, DA (corresponding author), King Faisal Specialist Hosp & Res Ctr, Organ Transplant Ctr Excellence, 7790,2609 Al Maather, Riyadh 12713, Saudi Arabia. g.fusai@ucl.ac.uk; dimitri.raptis@gmail.com |
Document URI: | http://hdl.handle.net/1942/42392 | ISSN: | 0007-1323 | e-ISSN: | 1365-2168 | DOI: | 10.1093/bjs/znad330 | ISI #: | 001099633000001 | Rights: | The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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