Risk-adjustment in hepatobiliarypancreatic surgery

Table 6 Multivariate ordered logistic regression analysis of risk factors for HPB surgery.

Factor	Category	Estimate (b)	Adjusted OR	CI 95%
Physiological	10-1 units increase		1.18	1.07, 1.31
score-
POSSUM
INR2	10-2 units increase		1.47	1.12, 1.94
Blood loss	< 2 L		1
	>2 L		4.1	1.49, 11.13
Procedure	Right hepatectomy		1
	Pancreaticoduodenectomy		3.27	1.07, 9.97
Sub-factors of
POSSUM3
Serum sodium1	10-1 units increase		0.89	0.82, 0.97
Serum creatinine	10-1 units increase		1.01	1.00, 1.02
Pulse rate (bpm)	10-1 units increase		1.04	1.01, 1.06

¹OR denotes that patients do worse with every unit decrease in sodium below the lower limit of normal range (130 mmol/L).

²OR denotes that patients do worse with every 0.1 unit increase in INR above 1.1.

³When the physiological score of the POSSUM variables are analyzed separately with multifactorial ordered logistic regression, the significant factors are sodium, creatinine and pulse rate which affect mortality and morbidity.