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Complications After Liver Surgery: a Benchmark Analysis

2019Journal article Open access
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dc.contributor.authorBagante, F
dc.contributor.authorRuzzenente, A
dc.contributor.authorBeal, E
dc.contributor.authorCampagnaro, T
dc.contributor.authorMerath, K
dc.contributor.authorConci, S
dc.contributor.authorAkgül, O
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorLam, V
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, G
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorIacono, C
dc.contributor.authorGuglielmi, A
dc.contributor.authorPawlik, T
dc.date.accessioned2021-09-07T15:15:10Z
dc.date.available2021-09-07T15:15:10Z
dc.date.issued2019
dc.description.abstractBackground: The best achievable short-term outcomes after liver surgery have not been identified. Several factors may influence the post-operative course of patients undergoing hepatectomy increasing the risk of post-operative complications. We sought to identify risk-adjusted benchmark values [BMV] for liver surgery. Methods: The National Surgery Quality Improvement Program (NSQIP) database was used to develop Bayesian models to estimate risk-adjusted BMVs for overall and liver related (post-hepatectomy liver failure [PHLF], biliary leakage [BL]) complications. A separate international multi-institutional database was used to validate the risk-adjusted BMVs. Results: Among the 11,243 patients included in the NSQIP database, the incidence of complications, PHLF, and BL was 36%, 5%, and 8%, respectively. The risk-adjusted BMVs for complication (range, 16-72%), PHLF (range, 1%-20%), and BL (range, 4%-22%) demonstrated a high variability based on patients characteristics. When tested using an international database including nine institutes, the risk-adjusted BMVs for complications ranged from 26% (Institute-4) to 43% (Institute-1), BMVs for PHLF between 3% (Institute-3) and 12% (Institute-5), while BMVs for BL ranged between 5% (Institute-4) and 9% (Institute-7). Conclusions: Multiple factors influence the risk of complications following hepatectomy. Risk-adjusted BMVs are likely much more applicable and appropriate in assessing "acceptable" benchmark outcomes following liver surgery.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHPB (Oxford). 2019 Sep;21(9):1139-1149.pt_PT
dc.identifier.doi10.1016/j.hpb.2018.12.013.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3840
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectBayes Theorempt_PT
dc.subjectBenchmarkingpt_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectInternationalitypt_PT
dc.subjectPostoperative Complications / epidemiologypt_PT
dc.titleComplications After Liver Surgery: a Benchmark Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1149pt_PT
oaire.citation.startPage1139pt_PT
oaire.citation.titleHPB (Oxford)pt_PT
oaire.citation.volume21pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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