title: Effect of epidural analgesia on postoperative complications following pancreaticoduodenectomy.
abstract: BACKGROUND
  The purpose of this study was to evaluate the effect of epidural analgesia use on postoperative complications in patients undergoing pancreaticoduodenectomy.
  
  
  METHODS
  This retrospective cohort study used the 2009 Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality. Patients who underwent pancreaticoduodenectomy were grouped on the basis of whether they received epidural analgesia. The effect of epidural use on the composite end point of major complications including death was investigated using a generalized linear model.
  
  
  RESULTS
  Overall, 8,610 cases of pancreaticoduodenectomy occurred within the United States in 2009, and 11.0% of these patients received epidural analgesia. After controlling for various potential confounders, results of the multivariate regression indicated that epidural analgesia use was associated with lower odds of composite complications including death (odds ratio, .61; 95% confidence interval, .37-.99; P = .044).
  
  
  CONCLUSIONS
  In patients who underwent pancreaticoduodenectomy, epidural analgesia was associated with significantly lower postoperative composite complications.
authors.affiliation: College of Medicine, Department of Surgery, The University of Arizona, Tucson, AZ, USA. albertamini23@gmail.com
authors.forename: Albert
authors.initials: A
authors.lastname: Amini
authors.forename: Asad E
authors.initials: AE
authors.lastname: Patanwala
authors.forename: Felipe B
authors.initials: FB
authors.lastname: Maegawa
authors.forename: Grant H
authors.initials: GH
authors.lastname: Skrepnek
authors.forename: Tun
authors.initials: T
authors.lastname: Jie
authors.forename: Rainer W
authors.initials: RW
authors.lastname: Gruessner
authors.forename: Evan S
authors.initials: ES
authors.lastname: Ong
mesh_terms: D015360:Analgesia, Epidural / Q000191:economics / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010149:Postoperative Pain / Q000517:prevention & control; D016577:Pancreaticoduodenectomy / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000191:economics / Q000379:methods*; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States