Journal of Gastrointestinal Surgery

, Volume 18, Issue 3, pp 512–522

Impact of Cardiac Comorbidity on Early Outcomes after Pancreatic Resection

  • Sean M. Ronnekleiv-Kelly
  • David Y. Greenblatt
  • Chee Paul Lin
  • Kaitlyn J. Kelly
  • Clifford S. Cho
  • Emily R. Winslow
  • Sharon M. Weber
Original Article

Abstract

Background

In patients undergoing pancreatic resection (PR), identification of subgroups at increased risk for postoperative complications can allow focused interventions that may improve outcomes.

Study Design

Patients undergoing PR from 2005–2010 were selected from the American College of Surgeons National Surgical Quality Improvement Program database and categorized as having any history of cardiac disease (angina, congestive heart failure (CHF), myocardial infarction (MI), cardiac stent, or bypass) or as having acute cardiac disease (symptoms of CHF or angina within 30 days or MI within 6 months). These variables were utilized to examine the relationship between cardiac disease and outcomes after PR.

Results

The rate of serious complications and perioperative mortality in patients with any history of cardiac disease vs. those without was 34 vs. 24 % (p < 0.001) and 4.5 vs. 2.0 % (p < 0.001), respectively, and in patients with acute cardiac disease compared to patients without was 37 vs. 25 % (p < 0.001) and 8.6 vs. 2.2 % (p < 0.001), respectively. In multivariate analysis, the two cardiac disease variables remained associated with mortality.

Conclusions

In patients undergoing PR, cardiac disease is a significant risk factor for adverse outcomes. These observations are critical for meaningful informed consent in patients considering pancreatectomy.

Keywords

Pancreatic resection Pancreatic surgery Cardiac disease American College of Surgeons National Surgical Quality Improvement Program Surgical outcomes 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Sean M. Ronnekleiv-Kelly
    • 1
  • David Y. Greenblatt
    • 1
  • Chee Paul Lin
    • 1
  • Kaitlyn J. Kelly
    • 2
  • Clifford S. Cho
    • 1
  • Emily R. Winslow
    • 1
  • Sharon M. Weber
    • 1
  1. 1.Department of SurgeryUniversity of WisconsinMadisonUSA
  2. 2.Department of SurgeryUniversity of California, San DiegoSan DiegoUSA

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