Using the new procedure code, the ACS NSQIP Participant Use File database was queried for all patients who had debridement of pancreatic and peripancreatic necrosis from January 1 December 31, 2007. Preoperative, intraoperative and postoperative data variables are submitted on each patient, including the CPT codes. Patient demographics, observed (O) and expected (E) morbidity and mortality, and indices (O/E) were evaluated. A multivariate stepwise logistic regression was performed to determine predictors of mortality.
Survivors and nonsurvivors were compared with respect to patient demographics, comorbidities, and postoperative outcomes. On average, non-survivors were 17 years older and had a significantly higher body mass index (35.6kg/m2) versus survivors (29.8kg/m2, p<0.01). The majority of patients were Caucasian (n=121), 29 percent had diabetes (n=47), and 11 percent (n=18) abused alcohol. Of note, 24 percent (n=39) of these patients were transferred to ACS NSQIP hospitals from other facilities.
During the 12-month period, postoperative morbidity was high at 62 percent (n=100), but less than expected (72 percent, n=116). Thirty-day hospital mortality was 6.8 percent (n=11), only one-third of the 20.6 percent (n=33) predicted by the ACS NSQIP logistic regression, risk-adjustment formula.
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Weber Shandwick Worldwide