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Preoperative Nomogram Predicts Non-home Discharge in Patients Undergoing Pancreatoduodenectomy
Background In patients undergoing pancreatoduodenectomy, non-home discharge is common and often results in an unnecessary delay in hospital discharge. This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following...
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| Published in: | Journal of gastrointestinal surgery 2021-05, Vol.25 (5), p.1253-1260 |
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| Main Authors: | , , , , , , , , , , |
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| container_end_page | 1260 |
| container_issue | 5 |
| container_start_page | 1253 |
| container_title | Journal of gastrointestinal surgery |
| container_volume | 25 |
| creator | Flick, Katelyn F. Schmidt, C. Max Colgate, Cameron L. Yip-Schneider, Michele T. Sublette, Chris M. Maatman, Thomas K. Soufi, Mazhar Ceppa, Eugene P. House, Michael G. Zyromski, Nicholas J. Nakeeb, Attila |
| description | Background
In patients undergoing pancreatoduodenectomy, non-home discharge is common and often results in an unnecessary delay in hospital discharge. This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following pancreatoduodenectomy.
Methods
Patients undergoing pancreatoduodenectomy from 2013 to 2018 were identified using an institutional database. Patients were categorized according to discharge location (home vs. non-home). Preoperative risk factors, including social determinants of health associated with non-home discharge, were identified using Pearson’s chi-squared test and then included in a multiple logistic regression model. A training cohort composed of 80% of the sampled patients was used to create the prediction model, and validation carried out using the remaining 20%. Statistical significance was defined as
P
|
| doi_str_mv | 10.1007/s11605-020-04689-1 |
| format | article |
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In patients undergoing pancreatoduodenectomy, non-home discharge is common and often results in an unnecessary delay in hospital discharge. This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following pancreatoduodenectomy.
Methods
Patients undergoing pancreatoduodenectomy from 2013 to 2018 were identified using an institutional database. Patients were categorized according to discharge location (home vs. non-home). Preoperative risk factors, including social determinants of health associated with non-home discharge, were identified using Pearson’s chi-squared test and then included in a multiple logistic regression model. A training cohort composed of 80% of the sampled patients was used to create the prediction model, and validation carried out using the remaining 20%. Statistical significance was defined as
P
< 0.05.
Results
Seven hundred sixty-six pancreatoduodenectomy patients met the study criteria for inclusion in the analysis (non-home, 126; home, 640). Independent predictors of non-home discharge on multivariable analysis were age, marital status, mental health diagnosis, functional health status, dyspnea, and chronic obstructive pulmonary disease. The prediction model was then used to generate a nomogram to predict likelihood of non-home discharge. The training and validation cohorts demonstrated comparable performances with an identical area under the curve (0.81) and an accuracy of 84%.
Conclusion
A prediction model to reliably assess the likelihood of non-home discharge after pancreatoduodenectomy was developed and validated in the present study.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-020-04689-1</identifier><identifier>PMID: 32583325</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Age ; Cancer ; Discharge ; Dyspnea ; Gastroenterology ; Hospitals ; Humans ; Logistic Models ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Mental health ; Nomograms ; Nursing ; Original Article ; Pancreas ; Pancreaticoduodenectomy ; Pancreaticoduodenectomy - adverse effects ; Patient Discharge ; Perioperative care ; Postoperative period ; Rehabilitation ; Risk Factors ; Surgery</subject><ispartof>Journal of gastrointestinal surgery, 2021-05, Vol.25 (5), p.1253-1260</ispartof><rights>The Society for Surgery of the Alimentary Tract 2020</rights><rights>The Society for Surgery of the Alimentary Tract 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-1deaeb457c48badf3ba40496a972586c55939622519739cdc6ea9bbadf59f6783</citedby><cites>FETCH-LOGICAL-c419t-1deaeb457c48badf3ba40496a972586c55939622519739cdc6ea9bbadf59f6783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32583325$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flick, Katelyn F.</creatorcontrib><creatorcontrib>Schmidt, C. Max</creatorcontrib><creatorcontrib>Colgate, Cameron L.</creatorcontrib><creatorcontrib>Yip-Schneider, Michele T.</creatorcontrib><creatorcontrib>Sublette, Chris M.</creatorcontrib><creatorcontrib>Maatman, Thomas K.</creatorcontrib><creatorcontrib>Soufi, Mazhar</creatorcontrib><creatorcontrib>Ceppa, Eugene P.</creatorcontrib><creatorcontrib>House, Michael G.</creatorcontrib><creatorcontrib>Zyromski, Nicholas J.</creatorcontrib><creatorcontrib>Nakeeb, Attila</creatorcontrib><title>Preoperative Nomogram Predicts Non-home Discharge in Patients Undergoing Pancreatoduodenectomy</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
In patients undergoing pancreatoduodenectomy, non-home discharge is common and often results in an unnecessary delay in hospital discharge. This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following pancreatoduodenectomy.
Methods
Patients undergoing pancreatoduodenectomy from 2013 to 2018 were identified using an institutional database. Patients were categorized according to discharge location (home vs. non-home). Preoperative risk factors, including social determinants of health associated with non-home discharge, were identified using Pearson’s chi-squared test and then included in a multiple logistic regression model. A training cohort composed of 80% of the sampled patients was used to create the prediction model, and validation carried out using the remaining 20%. Statistical significance was defined as
P
< 0.05.
Results
Seven hundred sixty-six pancreatoduodenectomy patients met the study criteria for inclusion in the analysis (non-home, 126; home, 640). Independent predictors of non-home discharge on multivariable analysis were age, marital status, mental health diagnosis, functional health status, dyspnea, and chronic obstructive pulmonary disease. The prediction model was then used to generate a nomogram to predict likelihood of non-home discharge. The training and validation cohorts demonstrated comparable performances with an identical area under the curve (0.81) and an accuracy of 84%.
Conclusion
A prediction model to reliably assess the likelihood of non-home discharge after pancreatoduodenectomy was developed and validated in the present study.</description><subject>Age</subject><subject>Cancer</subject><subject>Discharge</subject><subject>Dyspnea</subject><subject>Gastroenterology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental health</subject><subject>Nomograms</subject><subject>Nursing</subject><subject>Original Article</subject><subject>Pancreas</subject><subject>Pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - adverse effects</subject><subject>Patient Discharge</subject><subject>Perioperative care</subject><subject>Postoperative period</subject><subject>Rehabilitation</subject><subject>Risk Factors</subject><subject>Surgery</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kE9LHTEUxYO0qFW_QBdloBs3aXPzd7IstlZBqguFrhoymfvGkTfJazJT8Ns3-rRCF26ScO7vnhwOIe-BfQLGzOcCoJmijDPKpG4thR2yD60RVGqu39Q3s0C5Uj_3yLtS7hgDw6DdJXuCq1bUY5_8usqYNpj9PP7B5kea0pD91FS1H8NcqhLpbZqw-TqWcOvzgM0Ym6uKY6zjm9hjHtIYh6rFkNHPqV9SjxHDnKb7Q_J25dcFj57uA3Jz-u365IxeXH4_P_lyQYMEO1Po0WMnlQmy7Xy_Ep2XTFrtralJdVDKCqs5V2CNsKEPGr3tHkhlV9q04oAcb303Of1esMxuqnlxvfYR01Icl2AkU6zlFf34H3qXlhxrOscVhxaMEKpSfEuFnErJuHKbPE4-3ztg7qF9t23f1fbdY_sO6tKHJ-ulm7D_t_JcdwXEFih1FAfML3-_YvsXqfaQdg</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Flick, Katelyn F.</creator><creator>Schmidt, C. Max</creator><creator>Colgate, Cameron L.</creator><creator>Yip-Schneider, Michele T.</creator><creator>Sublette, Chris M.</creator><creator>Maatman, Thomas K.</creator><creator>Soufi, Mazhar</creator><creator>Ceppa, Eugene P.</creator><creator>House, Michael G.</creator><creator>Zyromski, Nicholas J.</creator><creator>Nakeeb, Attila</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20210501</creationdate><title>Preoperative Nomogram Predicts Non-home Discharge in Patients Undergoing Pancreatoduodenectomy</title><author>Flick, Katelyn F. ; Schmidt, C. Max ; Colgate, Cameron L. ; Yip-Schneider, Michele T. ; Sublette, Chris M. ; Maatman, Thomas K. ; Soufi, Mazhar ; Ceppa, Eugene P. ; House, Michael G. ; Zyromski, Nicholas J. ; Nakeeb, Attila</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-1deaeb457c48badf3ba40496a972586c55939622519739cdc6ea9bbadf59f6783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Cancer</topic><topic>Discharge</topic><topic>Dyspnea</topic><topic>Gastroenterology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental health</topic><topic>Nomograms</topic><topic>Nursing</topic><topic>Original Article</topic><topic>Pancreas</topic><topic>Pancreaticoduodenectomy</topic><topic>Pancreaticoduodenectomy - adverse effects</topic><topic>Patient Discharge</topic><topic>Perioperative care</topic><topic>Postoperative period</topic><topic>Rehabilitation</topic><topic>Risk Factors</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Flick, Katelyn F.</creatorcontrib><creatorcontrib>Schmidt, C. Max</creatorcontrib><creatorcontrib>Colgate, Cameron L.</creatorcontrib><creatorcontrib>Yip-Schneider, Michele T.</creatorcontrib><creatorcontrib>Sublette, Chris M.</creatorcontrib><creatorcontrib>Maatman, Thomas K.</creatorcontrib><creatorcontrib>Soufi, Mazhar</creatorcontrib><creatorcontrib>Ceppa, Eugene P.</creatorcontrib><creatorcontrib>House, Michael G.</creatorcontrib><creatorcontrib>Zyromski, Nicholas J.</creatorcontrib><creatorcontrib>Nakeeb, Attila</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Flick, Katelyn F.</au><au>Schmidt, C. Max</au><au>Colgate, Cameron L.</au><au>Yip-Schneider, Michele T.</au><au>Sublette, Chris M.</au><au>Maatman, Thomas K.</au><au>Soufi, Mazhar</au><au>Ceppa, Eugene P.</au><au>House, Michael G.</au><au>Zyromski, Nicholas J.</au><au>Nakeeb, Attila</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Nomogram Predicts Non-home Discharge in Patients Undergoing Pancreatoduodenectomy</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>25</volume><issue>5</issue><spage>1253</spage><epage>1260</epage><pages>1253-1260</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
In patients undergoing pancreatoduodenectomy, non-home discharge is common and often results in an unnecessary delay in hospital discharge. This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following pancreatoduodenectomy.
Methods
Patients undergoing pancreatoduodenectomy from 2013 to 2018 were identified using an institutional database. Patients were categorized according to discharge location (home vs. non-home). Preoperative risk factors, including social determinants of health associated with non-home discharge, were identified using Pearson’s chi-squared test and then included in a multiple logistic regression model. A training cohort composed of 80% of the sampled patients was used to create the prediction model, and validation carried out using the remaining 20%. Statistical significance was defined as
P
< 0.05.
Results
Seven hundred sixty-six pancreatoduodenectomy patients met the study criteria for inclusion in the analysis (non-home, 126; home, 640). Independent predictors of non-home discharge on multivariable analysis were age, marital status, mental health diagnosis, functional health status, dyspnea, and chronic obstructive pulmonary disease. The prediction model was then used to generate a nomogram to predict likelihood of non-home discharge. The training and validation cohorts demonstrated comparable performances with an identical area under the curve (0.81) and an accuracy of 84%.
Conclusion
A prediction model to reliably assess the likelihood of non-home discharge after pancreatoduodenectomy was developed and validated in the present study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32583325</pmid><doi>10.1007/s11605-020-04689-1</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Cancer Discharge Dyspnea Gastroenterology Hospitals Humans Logistic Models Medical diagnosis Medicine Medicine & Public Health Mental health Nomograms Nursing Original Article Pancreas Pancreaticoduodenectomy Pancreaticoduodenectomy - adverse effects Patient Discharge Perioperative care Postoperative period Rehabilitation Risk Factors Surgery |
| title | Preoperative Nomogram Predicts Non-home Discharge in Patients Undergoing Pancreatoduodenectomy |
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