Preoperative nomogram to predict risk of perioperative mortality following pancreatic resections for malignancy

J Gastrointest Surg. 2009 Dec;13(12):2152-62. doi: 10.1007/s11605-009-1051-z. Epub 2009 Oct 6.

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.

MeSH terms

  • Aged
  • Comorbidity
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Nomograms*
  • Pancreatectomy
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / surgery*