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Ideal Outcome After...
Ideal Outcome After Pancreatoduodenectomy : A Transatlantic Evaluation of a Harmonized Composite Outcome Measure
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- Augustinus, Simone (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- MacKay, Tara M. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- Andersson, Bodil (författare)
- Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,LUCC: Lund University Cancer Centre,Other Strong Research Environments
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- Beane, Joal D. (författare)
- Ohio State University
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- Busch, Olivier R. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- Gleeson, Elizabeth M. (författare)
- University of North Carolina
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- Koerkamp, Bas G. (författare)
- Erasmus University Medical Center
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- Keck, Tobias (författare)
- University Medical Center Schleswig-Holstein
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- Van Santvoort, Hjalmar C. (författare)
- University Medical Center Utrecht
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- Tingstedt, Bobby (författare)
- Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,LUCC: Lund University Cancer Centre,Other Strong Research Environments
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- Wellner, Ulrich F. (författare)
- University Medical Center Schleswig-Holstein
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- Williamsson, Caroline (författare)
- Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,LUCC: Lund University Cancer Centre,Other Strong Research Environments
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- Besselink, Marc G. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- Pitt, Henry A. (författare)
- Rutgers Cancer Institute of New Jersey
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(creator_code:org_t)
- 2023
- 2023
- Engelska 8 s.
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Ingår i: Annals of Surgery. - 0003-4932. ; 278:5, s. 740-747
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: The aim of this study is to define and assess Ideal Outcome in the national or multicenter registries of North America, Germany, the Netherlands, and Sweden. Background: Assessing outcomes after pancreatoduodenectomy among centers and countries requires a broad evaluation that cannot be captured by a single parameter. Previously, 2 composite outcome measures (textbook outcome and optimal pancreatic surgery) for pancreatoduodenectomy have been described from Europe and the United States. These composites were harmonized into ideal outcome (IO). Methods: This analysis is a transatlantic retrospective study (2018-2020) of patients after pancreatoduodenectomy within the registries from North America, Germany, The Netherlands, and Sweden. After 3 consensus meetings, IO for pancreatoduodenectomy was defined as the absence of all 6 parameters: (1) in-hospital mortality, (2) severe complications - Clavien-Dindo ≥3, (3) postoperative pancreatic fistula - International Study Group of Pancreatic Surgery (ISGPS) grade B/C, (4) reoperation, (5) hospital stay >75th percentile, and (6) readmission. Outcomes were evaluated using relative largest difference (RLD) and absolute largest difference (ALD), and multivariate regression models. Results: Overall, 21,036 patients after pancreatoduodenectomy were included, of whom 11,194 (54%) reached IO. The rate of IO varied between 55% in North America, 53% in Germany, 52% in The Netherlands, and 54% in Sweden (RLD: 1.1, ALD: 3%, P<0.001). Individual components varied with an ALD of 2% length of stay, 4% for in-hospital mortality, 12% severe complications, 10% postoperative pancreatic fistula, 11% reoperation, and 9% readmission. Age, sex, absence of chronic obstructive pulmonary disease, body mass index, performance status, American Society of Anesthesiologists (ASA) score, biliary drainage, absence of vascular resection, and histologic diagnosis were associated with IO. In the subgroup of patients with pancreatic adenocarcinoma, country, and neoadjuvant chemotherapy also was associated with improved IO. Conclusions: The newly developed composite outcome measure "Ideal Outcome"can be used for auditing and comparing outcomes after pancreatoduodenectomy. The observed differences can be used to guide collaborative initiatives to further improve the outcomes of pancreatic surgery.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- composite outcome
- ideal outcome
- pancreatoduodenectomy
- transatlantic
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Augustinus, Simo ...
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MacKay, Tara M.
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Andersson, Bodil
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Beane, Joal D.
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Busch, Olivier R ...
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Gleeson, Elizabe ...
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Koerkamp, Bas G.
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Keck, Tobias
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Van Santvoort, H ...
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Tingstedt, Bobby
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Wellner, Ulrich ...
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Williamsson, Car ...
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Besselink, Marc ...
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Pitt, Henry A.
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
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Annals of Surger ...
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Lunds universitet