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Role of Patient Selection for Pancreatic Resections

Completed
Conditions
Pancreas Disease
Interventions
Other: Persons with pancreatic resection in a hospital with at least 50 pancreatic resections annually (observational),
Other: Persons with pancreatic resection in a hospital not performing at least 50 pancreatic resections annually (observational),
Registration Number
NCT06390891
Lead Sponsor
Medizinische Hochschule Brandenburg Theodor Fontane
Brief Summary

Pancreatic surgery is complicated and risky, especially for pancreatic cancer. It's been noticed that having these surgeries done at specialized centers can lead to better outcomes and survival rates. However, factors like patient selection and hospital conditions also play an important role. Some studies show that more surgeries done at a hospital might not always mean better results, as the type of patients and procedures can vary. To understand this better, the present study compared outcomes and patient characteristics between high-volume pancreatic centers and others.

Detailed Description

The study utilized German nationwide administrative data (diagnosis-related group statistics) spanning from 2010 to 2018. Persons who underwent pancreatic resections during this period were included, with exclusions for certain criteria like underage and type of procedure. Various factors including patient demographics, diagnoses, procedures, and comorbidities were analyzed to assess in-hospital mortality rates. High-volume pancreatic centers (HVPCs) were identified as those performing at least 50 procedures annually. Statistical analyses included comparing crude and adjusted mortality rates and assessing patient characteristics between HVPCs and non-HVPCs. Models were adjusted for multiple variables, and methods like the Cochran-Armitage trend test and mixed models were employed. Additionally, the study investigated how differences in patient characteristics between HVPCs and non-HVPCs affected mortality rates.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
86073
Inclusion Criteria
  • partial or total pancreatic resections between 2010 and 2018
Exclusion Criteria
  • childhood (<18 years)
  • subjects with a pancreatic transplantation procedure
  • missing information on age or gender

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients treated in high-volume pancreatic centersPersons with pancreatic resection in a hospital with at least 50 pancreatic resections annually (observational),Patients treated at a hospital performing at least 50 pancreatic resection procedures annually during 2010 to 2018
Patients treated in low-volume pancreatic centersPersons with pancreatic resection in a hospital not performing at least 50 pancreatic resections annually (observational),Patients not treated at a hospital performing at least 50 pancreatic resection procedures annually during 2010 to 2018
Primary Outcome Measures
NameTimeMethod
In-hospital mortality30 days

Death

Secondary Outcome Measures
NameTimeMethod
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