title: Preoperative nomogram to predict risk of perioperative mortality following pancreatic resections for malignancy.
abstract: BACKGROUND
  The majority of pancreatic resections for malignancy are performed in older patients with major comorbidities. The aim of this study was to develop a preoperative nomogram based on the presence of comorbidities to predict risk of perioperative mortality.
  
  
  METHODS
  The National Inpatient Sample database was queried to identify patients that underwent pancreatectomy for malignancy. The preoperative comorbidities identified as predictors were used, and a nomogram was created. Sample A (2000-2004) was utilized to develop the model, and sample B (2005) was utilized to validate this model.
  
  
  RESULTS
  The overall actual observed perioperative mortality rate for samples A and B was 6.3% and 5.2%, respectively. The mean total points calculated for sample A by the nomogram was 131.7 that translates to a nomogram-predicted mortality rate of 4.9%, which is similar to the actual mortality. The mean total points for sample B was 128.1, which translates to a nomogram-predicted mortality rate of 4.6%. The similarity of mortality rates as predicted by the nomogram and a concordance index of 0.76 shows good agreement between the data and the nomogram.
  
  
  CONCLUSIONS
  This preoperative nomogram has been shown to accurately predict the risk of perioperative mortality following pancreatectomy for malignancy.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Eppley Cancer Center, University of Nebraska Medical Centre, Omaha, NE, USA. care@unmc.edu
authors.forename: Chandrakanth
authors.initials: C
authors.lastname: Are
authors.forename: Chantal
authors.initials: C
authors.lastname: Afuh
authors.forename: Lavanya
authors.initials: L
authors.lastname: Ravipati
authors.forename: Aaron
authors.initials: A
authors.lastname: Sasson
authors.forename: Fred
authors.initials: F
authors.lastname: Ullrich
authors.forename: Lynette
authors.initials: L
authors.lastname: Smith
mesh_terms: D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D049451:Nomograms; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*