Early Postoperative Vital Signs Predict Subsequent 90-Day Mortality After Pancreaticoduodenectomy

Background While complication rates after pancreaticoduodenectomy (PD) have improved in recent decades, surgical-related death remains a possibility. Postoperative vital signs offer an untapped opportunity to identify predictors of 90-day mortality. Methods We performed a retrospective chart review...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2023-08, Vol.27 (8), p.1660-1667
Main Authors: Nerwal, Teena, Qoshe, Livia, Iyer, Sneha, Medina, Genevieve, Felix, Adrian, Lavu, Harish, Yeo, Charles J., Winter, Jordan M.
Format: Article
Language:English
Subjects:
Blood pressure
Gastroenterology
Humans
Medicine
Medicine & Public Health
Mortality
Original Article
Pancreatectomy - adverse effects
Pancreatic cancer
Pancreaticoduodenectomy
Pancreaticoduodenectomy - adverse effects
Postoperative Complications - etiology
Postoperative period
Retrospective Studies
Signs
Surgery
Vital Signs - physiology
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Summary:Background While complication rates after pancreaticoduodenectomy (PD) have improved in recent decades, surgical-related death remains a possibility. Postoperative vital signs offer an untapped opportunity to identify predictors of 90-day mortality. Methods We performed a retrospective chart review interrogating postoperative day (POD 0–7) vital sign measurements from patients undergoing a PD at Thomas Jefferson University Hospital, Philadelphia, PA (2009–2014). Five specific vital signs were examined as predictors of mortality: temperature, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure. Statistical analyses and logic algorithms were employed to rank vital sign parameters, with cut-points, to identify those associated with the highest risk of mortality and the most clinical relevance. Results In our cohort, 11/750 patients (1.5%) died within 30 days of surgery, and 21/750 patients (2.8%) died within 90 days of surgery. Vital sign perturbations associated with the highest risk of mortality included mean SBP 
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-022-05410-0