Community health indicators associated with outcomes of pancreatectomy.
OBJECTIVE
This study evaluates the association of environmental, social and health risk factors in relation to outcomes of pancreatic surgery.


METHODS
Patients who underwent pancreatectomy with a 30 day postoperative follow up in Florida, New York and Washington states were identified using the State Inpatient Databases (SID) from 2010 to 2011. This data was merged with community health indicators complied from the County Health Ranking database. Fourteen community health indicators were used to determine higher risk communities. Communities were then divided into low and high risk communities based on a scoring system using accumulative community risk.


RESULTS
Among 3494 patients included recipients in high-risk communities were more likely African American (p < 0.001), younger (age 40-59; p = 0.001), and had Medicaid as primary insurance (p = 0.001). Management of patients in high-risk communities was associated with increased risk of postoperative complications (p < 0.001), ICU admissions (p < 0.001), increased length of stay (p < 0.001).


CONCLUSIONS
Health indicators from patients' communities are predictors of increased risk of perioperative complications for individuals undergoing pancreas surgery.
Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: lslakey@tulane.edu.
Lauren Slakey
LS
Pointer
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: zalquray@tulane.edu.
Zaid
Z
Al-Qurayshi
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: dpointe@tulane.edu.
David Taylor
DT
Pointer
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: ekandil@tulane.edu.
Emad
E
Kandil
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: dslakey@tulane.edu.
Douglas Philip
DP
Slakey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004777:Environment; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D010180:Pancreatectomy; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D018570:Risk Assessment; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
Health indicators; Outcome disparities; Pancreatic surgery