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Approach to postpancreatectomy care Impacts outcomes: Retrospective Validation of the PORSCH trial.
Bloomfield, Grace C; Radkani, Pejman; Nigam, Aradhya; Namgoong, Jean; Chou, Jiling; Park, Byoung Uk; Fishbein, Thomas M; Winslow, Emily R.
Afiliación
  • Bloomfield GC; Georgetown University School of Medicine, Washington, DC, USA.
  • Radkani P; Department of Transplant Surgery, Medstar Georgetown University Hospital, Washington, DC, USA.
  • Nigam A; Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, USA.
  • Namgoong J; Georgetown University School of Medicine, Washington, DC, USA.
  • Chou J; MedStar Health Research Institute Department of Biostatistics & Biomedical Informatics, Hyattsville, MD, USA.
  • Park BU; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
  • Fishbein TM; Department of Transplant Surgery, Medstar Georgetown University Hospital, Washington, DC, USA.
  • Winslow ER; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: winslow@surgery.wisc.edu.
Am J Surg ; 237: 115765, 2024 Nov.
Article en En | MEDLINE | ID: mdl-38782685
ABSTRACT

BACKGROUND:

In the recent PORSCH trial, a three-part postpancreatectomy care algorithm was employed with a near 50 â€‹% reduction in mortality. We hypothesized that clinical care congruent with this protocol would correlate with better outcomes in our patients.

METHODS:

Real-world postoperative care was compared to the pathway described by the PORSCH trial and patients were assigned into groups based on congruence with its recommendations. The primary composite outcome (PCO) consisted of 90-day mortality, organ failure, and interventions for bleeding.

RESULTS:

Of 289 patients, care of 12 â€‹% was entirely congruent with the PORSCH algorithm. The PCO was recorded in 9 â€‹% of the PORSCH care group, 8 â€‹% of the Partial-PORSCH care group, and 19 â€‹% of the Non-PORSCH care group (p â€‹= â€‹0.044). Adverse outcomes were highest when pancreaticoduodenectomy patients received care incongruent with the algorithm's CT imaging recommendations.

CONCLUSIONS:

These results add external validity to the principles of clinical care underlying the PORSCH algorithm.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Posoperatorios / Algoritmos / Pancreaticoduodenectomía Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Posoperatorios / Algoritmos / Pancreaticoduodenectomía Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos