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dc.contributor.authorChua, TC
dc.contributor.authorMittal, A
dc.contributor.authorNahm, C
dc.contributor.authorHugh, TJ
dc.contributor.authorArena, J
dc.contributor.authorGill, AJ
dc.contributor.authorSamra, JS
dc.date.accessioned2019-09-11T03:50:58Z
dc.date.available2019-09-11T03:50:58Z
dc.date.issued2018
dc.identifier.issn1445-1433
dc.identifier.doi10.1111/ans.14191
dc.identifier.urihttp://hdl.handle.net/10072/387211
dc.description.abstractBackground: The impact of the public and private hospital systems on major abdominal operations that are demanding on clinical resources, such as pancreatic surgery, has not been explored in an Australian setting. This study examines the perioperative outcome of patients undergoing pancreatoduodenectomy (PD) at a major public and private hospital. Methods: Patients undergoing PD between January 2004 and October 2015 were classified based on their health insurance status and location of where the surgery was performed. Clinical variables relating to perioperative outcome were retrieved and compared using univariate and multivariate analyses. Results: Four hundred and twenty patients underwent PD of whom 232 patients (55%) were operated on in the private hospital. Overall, there was no difference in morbidity and mortality in the public versus the private hospital. However, there were variations in public versus private hospital, this included longer duration of surgery (443 min versus 372 min; P < 0.001), increased estimated blood loss (683 mL versus 506 mL; P < 0.001) and more patients requiring perioperative blood transfusion (25% versus 13%; P = 0.001). Of the 10 complications compared, post-operative bleeding was higher in the private hospital (11% versus 5%; P = 0.051) and intra-abdominal collections were more common in the public hospital (11% versus 5%; P = 0.028). Independent predictive factors for major complications were American Society of Anesthesiologists score (odds ratio (OR) = 1.91; P = 0.050), patients requiring additional visceral resection (OR = 3.36; P = 0.014) and post-operative transfusion (OR = 3.37; P < 0.001). The hospital type (public/private) was not associated with perioperative outcome. Conclusion: Comparable perioperative outcomes were observed between patients undergoing PD in a high-volume specialized unit in both the public and private hospital systems.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley
dc.publisher.placeAustralia
dc.relation.ispartofpagefromE526
dc.relation.ispartofpagetoE531
dc.relation.ispartofissue6
dc.relation.ispartofjournalANZ Journal of Surgery
dc.relation.ispartofvolume88
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode1103
dc.subject.keywordsAustralia
dc.subject.keywordscomplication
dc.subject.keywordshealthcare system
dc.subject.keywordsmortality
dc.subject.keywordspancreatic cancer
dc.titlePancreatoduodenectomy in a public versus private teaching hospital is comparable with some minor variations
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationChua, TC; Mittal, A; Nahm, C; Hugh, TJ; Arena, J; Gill, AJ; Samra, JS, Pancreatoduodenectomy in a public versus private teaching hospital is comparable with some minor variations, ANZ Journal of Surgery, 2018, 88 (6), pp. E526-E531
dcterms.dateAccepted2017-07-18
dc.date.updated2019-09-11T01:50:39Z
gro.hasfulltextNo Full Text
gro.griffith.authorChua, Terence


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