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WHipple-ABACUS, a simple, validated risk score for 30-day mortality after pancreaticoduodenectomy developed using the ACS-NSQIP database
Journal article   Peer reviewed

WHipple-ABACUS, a simple, validated risk score for 30-day mortality after pancreaticoduodenectomy developed using the ACS-NSQIP database

Elizabeth M. Gleeson, Mohammad F. Shaikh, Patricia A. Shewokis, John R. Clarke, William C. Meyers, Henry A. Pitt and Wilbur B. Bowne
Surgery, v 160(5), pp 1279-1287
01 Nov 2016
DOI: https://doi.org/10.1016/j.surg.2016.06.040
PMID: 27544541
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Background. Pancreaticoduodenectomy needs simple, validated risk models to better identify 30-day mortality. The goal of this study is to develop a simple risk score to predict 30-day mortality after pancreaticoduodenectomy. Methods. We reviewed cases of pancreaticoduodenectomy from 2005-2012 in the American College of Surgeons-National Surgical Quality Improvement Program databases. Logistic regression was used to identify preoperative risk factors for morbidity and mortality from a development cohort. Scores were created using weighted beta coefficients, and predictive accuracy was assessed on the validation cohort using receiver operator characteristic curves and measuring area under the curve. Results. The 30-day mortality rate was 2.7% for patients who underwent pancreaticoduodenectomy (n = 14,993). We identified 8 independent risk factors. The score created from weighted beta coefficients had an area under the curve of 0.71 (95% confidence interval, 0.66-0.77) on the validation cohort. Using the score WHipple-ABACUS (hypertension With medication + History of cardiac surgery + Age > 62 + 2 X Bleeding disorder + Albumin <3.5 g/dL + 2 X disseminated Cancer + 2 X Use of steroids + 2 X Systemic inflammatory response syndrome), mortality rates increase with increasing score (P < .001). Conclusion. While other risk scores exist for 30-day mortality after pancreaticoduodenectomy, we present a simple, validated score developed using exclusively preoperative predictors surgeons could use to identify patients at risk for this procedure.

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Surgery
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