Role of Patient Selection for Pancreatic Resections

NCT ID: NCT06390891

Last Updated: 2024-04-30

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 86073 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2010-01-01
• Study Completion Date: 2018-12-31

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.

Conditions

Pancreas Disease

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

Patients treated in high-volume pancreatic centers

Patients treated at a hospital performing at least 50 pancreatic resection procedures annually during 2010 to 2018

Persons with pancreatic resection in a hospital with at least 50 pancreatic resections annually (observational),

Intervention Type: OTHER

Persons that have undergone a pancreatic resection at a hospital with at least 50 pancreatic resections annually (observational)

Patients treated in low-volume pancreatic centers

Patients not treated at a hospital performing at least 50 pancreatic resection procedures annually during 2010 to 2018

Persons with pancreatic resection in a hospital not performing at least 50 pancreatic resections annually (observational),

Intervention Type: OTHER

Persons that have undergone a pancreatic resection at a hospital with not at least 50 pancreatic resections annually (observational)

Interventions

Persons with pancreatic resection in a hospital with at least 50 pancreatic resections annually (observational),

Persons that have undergone a pancreatic resection at a hospital with at least 50 pancreatic resections annually (observational)

Intervention Type: OTHER

Persons with pancreatic resection in a hospital not performing at least 50 pancreatic resections annually (observational),

Persons that have undergone a pancreatic resection at a hospital with not at least 50 pancreatic resections annually (observational)

Intervention Type: OTHER

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Medizinische Hochschule Brandenburg Theodor Fontane

OTHER

Sponsor Role: lead

Responsible Party

Rene Mantke

Head of Surgery

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Rene Mantke, MD, PhD

Role: STUDY_DIRECTOR

Head of Surgery at University Hospital Brandenburg an der Havel

References

Mantke R, Seliger B, Ogino S, Buchler MW, Hunger R. Not Only Caseload but Also Patient Selection Is Predictive of Mortality After Pancreatic Resection. Ann Surg Open. 2024 Dec 30;6(1):e536. doi: 10.1097/AS9.0000000000000536. eCollection 2025 Mar.

Reference Type: DERIVED

PMID: 40134472 (View on PubMed)

Other Identifiers

PatSelPanc

Identifier Type: -

Identifier Source: org_study_id