Perioperative mortality after pancreatectomy: A risk score to aid decision-making

Prediction of in-hospital mortality after pancreatic resection in pancreatic cancer patients: A boosting approach via a population-based study using health administrative data

“…This value is surprisingly high compared to those of previous reports [5, 6, 9, 26, 27] but is aligned with some other reports publishing mortality rates close to 10% [28–30] and up to 14% [31]. These differences may be attributable to the fact that the studies reporting lower rates were conducted in individual centers [9] with high volumes of surgeries and experienced surgeons; indeed, these variables have been proven to enhance in-hospital mortality.…”

“…Boosting made including the individual information of each patient’s diagnosis, thereby avoiding the aggregation of diagnoses as in typical co-morbidity indexes, possible [37, 38]. We believe that this method allowed us to achieve an AUC of 0.916 in the validation set, which is considerably higher than those of other approximations, which generated values of barely 0.72 [5, 6, 10, 11]. Moreover, the proposed model also achieved success rates exceeding 90% and well-calibrated probabilities.…”

“…To the best of our knowledge, this is the first study in which all diagnoses related to death were used to build a predictive model instead of the co-morbidity indexes [5, 6] or the co-morbidities that compose such indexes [39]. This is mainly attributable to two reasons: First, the use of a co-morbidity index does not provide a differential element when classifying patients because even when patients exhibited the same values (for example, the same demographic characteristics, same hospital volume and the same co-morbidity index), some dies and others did not.…”

Diagnosis and Management of Borderline Resectable Pancreatic Adenocarcinoma

“…Although historically this has been a relatively subjective assessment, useful tools now exist with which a personalized assessment of risk based on age, comorbidities, and frailty can be calculated. 32,33 Patients with type C should be managed actively in a multidisciplinary group of expert physicians, including a dedicated pancreas program Schwarz & Katz dietician, physical therapist, and members of the internal medicine faculty to appropriately risk stratify and optimize each patient for eventual surgery.…”

Pancreatic surgery

“…Ragulin-Coyne et al [4] developed a perioperative mortality risk score from preoperative variables that is available online (www.umass.edu/ surgery/panc_mortality_custom.aspx). Ragulin-Coyne et al [4] developed a perioperative mortality risk score from preoperative variables that is available online (www.umass.edu/ surgery/panc_mortality_custom.aspx).…”