Regional variation in surgery for pancreatic cancer in Denmark 2011-2015

Kasper Wennervaldt; Anne Mette Kejs; Henriette Lipczak; Paul Bartels; Michael Borre; Claus Wilki Fristrup; Henrik Kehlet

Regional variation in surgery for pancreatic cancer in Denmark 2011-2015

Kasper Wennervaldt, Anne Mette Kejs, Henriette Lipczak, Paul Bartels, Michael Borre, Claus Wilki Fristrup, Henrik Kehlet

Institut for Klinisk Medicin

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Abstract

INTRODUCTION: Surgical treatment for pancreatic cancer carries a high risk of both morbidity and mortality. Even so, it remains the best curative treatment option. In Denmark, pancreatic surgery has been extensively centralised since the millennium, but the effect of this centralisation on patient outcome has not been evaluated. This study describes regional variation within pancreatic surgery on a malignant indication, focusing on production volume, length of stay, readmission rates and mortality. METHODS: This is a retrospective cohort study of all patients with pancreatic cancer who underwent surgical treatment in Denmark from 2011 to 2015. We obtained data from the Danish National Patient Registry and the National Pathology Data Bank on length of stay, transfers, mortality (both short and long term), age, co-morbidity, and disease stage. RESULTS: Four hospital units performed a total of 691 surgical procedures (476 pancreaticoduodenectomies) in the study period. Production volume varied considerably across units with two units accounting for nearly 80% of surgery performed. Data revealed variation on rates of transfers and readmissions as well as disease stage and mortality (both short and long term). CONCLUSIONS: Data suggest that mortality is linked to production volume as well as disease stage, but the small data quantity impedes rigorous statistical analysis. Further studies on the observed associations are required.none. TRIAL REGISTRATION: not relevant.

Originalsprog	Engelsk
Artikelnummer	A5503
Tidsskrift	Danish Medical Journal
Vol/bind	65
Udgave nummer	9
Antal sider	5
ISSN	1603-9629
Status	Udgivet - 1 sep. 2018

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Regional variation in surgery for pancreatic cancer in Denmark 2011-2015Forlagets udgivne version, 188 KBLicens: CC BY-NC

http://ugeskriftet.dk/dmj/regional-variation-surgery-pancreatic-cancer-denmark-2011-2015Licens: CC BY-NC

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title = "Regional variation in surgery for pancreatic cancer in Denmark 2011-2015",

abstract = "INTRODUCTION: Surgical treatment for pancreatic cancer carries a high risk of both morbidity and mortality. Even so, it remains the best curative treatment option. In Denmark, pancreatic surgery has been extensively centralised since the millennium, but the effect of this centralisation on patient outcome has not been evaluated. This study describes regional variation within pancreatic surgery on a malignant indication, focusing on production volume, length of stay, readmission rates and mortality. METHODS: This is a retrospective cohort study of all patients with pancreatic cancer who underwent surgical treatment in Denmark from 2011 to 2015. We obtained data from the Danish National Patient Registry and the National Pathology Data Bank on length of stay, transfers, mortality (both short and long term), age, co-morbidity, and disease stage. RESULTS: Four hospital units performed a total of 691 surgical procedures (476 pancreaticoduodenectomies) in the study period. Production volume varied considerably across units with two units accounting for nearly 80% of surgery performed. Data revealed variation on rates of transfers and readmissions as well as disease stage and mortality (both short and long term). CONCLUSIONS: Data suggest that mortality is linked to production volume as well as disease stage, but the small data quantity impedes rigorous statistical analysis. Further studies on the observed associations are required.none. TRIAL REGISTRATION: not relevant.",

keywords = "Adult, Aged, Comorbidity, Denmark/epidemiology, Female, Geography, Medical/statistics & numerical data, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Pancreatic Neoplasms/mortality, Pancreaticoduodenectomy/statistics & numerical data, Patient Readmission/statistics & numerical data, Retrospective Studies, Time Factors",

author = "Kasper Wennervaldt and Kejs, {Anne Mette} and Henriette Lipczak and Paul Bartels and Michael Borre and Fristrup, {Claus Wilki} and Henrik Kehlet",

note = "Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.",

year = "2018",

month = sep,

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T1 - Regional variation in surgery for pancreatic cancer in Denmark 2011-2015

AU - Wennervaldt, Kasper

AU - Kejs, Anne Mette

AU - Lipczak, Henriette

AU - Bartels, Paul

AU - Borre, Michael

AU - Fristrup, Claus Wilki

AU - Kehlet, Henrik

N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - INTRODUCTION: Surgical treatment for pancreatic cancer carries a high risk of both morbidity and mortality. Even so, it remains the best curative treatment option. In Denmark, pancreatic surgery has been extensively centralised since the millennium, but the effect of this centralisation on patient outcome has not been evaluated. This study describes regional variation within pancreatic surgery on a malignant indication, focusing on production volume, length of stay, readmission rates and mortality. METHODS: This is a retrospective cohort study of all patients with pancreatic cancer who underwent surgical treatment in Denmark from 2011 to 2015. We obtained data from the Danish National Patient Registry and the National Pathology Data Bank on length of stay, transfers, mortality (both short and long term), age, co-morbidity, and disease stage. RESULTS: Four hospital units performed a total of 691 surgical procedures (476 pancreaticoduodenectomies) in the study period. Production volume varied considerably across units with two units accounting for nearly 80% of surgery performed. Data revealed variation on rates of transfers and readmissions as well as disease stage and mortality (both short and long term). CONCLUSIONS: Data suggest that mortality is linked to production volume as well as disease stage, but the small data quantity impedes rigorous statistical analysis. Further studies on the observed associations are required.none. TRIAL REGISTRATION: not relevant.

AB - INTRODUCTION: Surgical treatment for pancreatic cancer carries a high risk of both morbidity and mortality. Even so, it remains the best curative treatment option. In Denmark, pancreatic surgery has been extensively centralised since the millennium, but the effect of this centralisation on patient outcome has not been evaluated. This study describes regional variation within pancreatic surgery on a malignant indication, focusing on production volume, length of stay, readmission rates and mortality. METHODS: This is a retrospective cohort study of all patients with pancreatic cancer who underwent surgical treatment in Denmark from 2011 to 2015. We obtained data from the Danish National Patient Registry and the National Pathology Data Bank on length of stay, transfers, mortality (both short and long term), age, co-morbidity, and disease stage. RESULTS: Four hospital units performed a total of 691 surgical procedures (476 pancreaticoduodenectomies) in the study period. Production volume varied considerably across units with two units accounting for nearly 80% of surgery performed. Data revealed variation on rates of transfers and readmissions as well as disease stage and mortality (both short and long term). CONCLUSIONS: Data suggest that mortality is linked to production volume as well as disease stage, but the small data quantity impedes rigorous statistical analysis. Further studies on the observed associations are required.none. TRIAL REGISTRATION: not relevant.

KW - Adult

KW - Aged

KW - Comorbidity

KW - Denmark/epidemiology

KW - Female

KW - Geography, Medical/statistics & numerical data

KW - Humans

KW - Length of Stay/statistics & numerical data

KW - Male

KW - Middle Aged

KW - Pancreatic Neoplasms/mortality

KW - Pancreaticoduodenectomy/statistics & numerical data

KW - Patient Readmission/statistics & numerical data

KW - Retrospective Studies

KW - Time Factors

M3 - Journal article

C2 - 30187862

SN - 2245-1919

VL - 65

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 9

M1 - A5503

ER -

Regional variation in surgery for pancreatic cancer in Denmark 2011-2015

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