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Article Abstract

Purpose: 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).

Conclusion: Health indicators from patients' communities are predictors of increased risk of perioperative complications for individuals undergoing pancreas surgery.

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http://dx.doi.org/10.1016/j.amjsurg.2017.02.010DOI Listing

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