Preoperative Nomogram to Predict Risk of Perioperative Mortality Following Pancreatic Resections for Malignancy

  • Chandrakanth Are
  • Chantal Afuh
  • Lavanya Ravipati
  • Aaron Sasson
  • Fred Ullrich
  • Lynette Smith
2009 SSAT Plenary Presentation

DOI: 10.1007/s11605-009-1051-z

Cite this article as:
Are, C., Afuh, C., Ravipati, L. et al. J Gastrointest Surg (2009) 13: 2152. doi:10.1007/s11605-009-1051-z

Abstract

Introduction

The majority of pancreatic resections for malignancy are performed in older patients with major comorbidities. The aim of this study was to develop a preoperative nomogram based on the presence of comorbidities to predict risk of perioperative mortality.

Materials and Methods

The National Inpatient Sample database was queried to identify patients that underwent pancreatectomy for malignancy. The preoperative comorbidities identified as predictors were used, and a nomogram was created. Sample A (2000–2004) was utilized to develop the model, and sample B (2005) was utilized to validate this model.

Results

The overall actual observed perioperative mortality rate for samples A and B was 6.3% and 5.2%, respectively. The mean total points calculated for sample A by the nomogram was 131.7 that translates to a nomogram-predicted mortality rate of 4.9%, which is similar to the actual mortality. The mean total points for sample B was 128.1, which translates to a nomogram-predicted mortality rate of 4.6%. The similarity of mortality rates as predicted by the nomogram and a concordance index of 0.76 shows good agreement between the data and the nomogram.

Conclusion

This preoperative nomogram has been shown to accurately predict the risk of perioperative mortality following pancreatectomy for malignancy.

Keywords

PancreatectomyMalignancyMortalityNomogram

Copyright information

© The Society for Surgery of the Alimentary Tract 2009

Authors and Affiliations

  • Chandrakanth Are
    • 1
    • 5
  • Chantal Afuh
    • 2
  • Lavanya Ravipati
    • 3
  • Aaron Sasson
    • 1
  • Fred Ullrich
    • 4
  • Lynette Smith
    • 4
  1. 1.Division of Surgical Oncology, Department of Surgery, Eppley Cancer CenterUniversity of Nebraska Medical CentreOmahaUSA
  2. 2.University of Nebraska College of MedicineOmahaUSA
  3. 3.Department of PathologyUniversity of Nebraska Medical CenterOmahaUSA
  4. 4.Department of Biostatistics, College of Public HealthUniversity of Nebraska Medical CentreOmahaUSA
  5. 5.Division of Surgical Oncology, Department of Surgery/Genetics Cell Biology and AnatomyUniversity of Nebraska Medical CenterOmahaUSA