Association of Advanced Practice Providers Integration With Postoperative Outcomes in Pancreatic Surgery

Area of Science:

• Surgical Oncology
• Gastroenterology
• Health Services Research

Background:

• Pancreatic surgery has high complication rates (30-50%) and readmission rates (30-40%).
• Lack of early postoperative issue identification and continuity of care contributes to adverse outcomes.

Purpose of the Study:

• To evaluate the impact of an Advanced Practice Provider (APP)-led structured follow-up protocol on pancreatic surgery outcomes.
• To assess the association of APP integration with readmission rates, length of stay (LOS), mortality, and failure-to-rescue (FTR) rates.

Main Methods:

• Single-institution, retrospective study of 290 patients undergoing pancreatic resection (2019-2024).
• Comparison of pre-APP (Jan 2019-Sep 2022) and post-APP (Jan 2023-Feb 2024) groups.
• APP aimed to evaluate all patients within 72 hours of discharge.

Main Results:

• The post-APP group had shorter index hospitalization LOS (6.9 vs. 8.6 days) and earlier first postoperative visits (4.9 vs. 10.1 days).
• Time to readmission after discharge was shorter in the post-APP group (8.1 vs. 11.3 days).
• Lower, though not statistically significant, 30-day mortality (1.0% vs. 4.2%) and FTR rates (1.6% vs. 5.8%) were observed post-APP integration.

Conclusions:

• APP integration with a structured follow-up protocol is associated with improved patient outcomes after pancreatic surgery.
• This approach facilitates earlier complication identification and reduces hospital LOS.
• The findings suggest a positive impact on patient recovery and potentially reduced mortality and FTR.