Table 3. Patient Demographic, Clinicopathologic, and Treatment Characteristics by Surgical Hospital Cost Quintile.
| Characteristic | Cost Quintilea | P Value | ||||
|---|---|---|---|---|---|---|
| Low (n = 557) | Low to Intermediate (n = 558) | Intermediate (n = 557) | Intermediate to High (n = 557) | High (n = 557) | ||
| Age, mean (SD), y | 65.7 (11.3) | 66.4 (10.7) | 66.6 (10.4) | 68.1 (10.7) | 68.0 (10.0) | <.001b |
| Male | 262 (47.0) | 287 (51.4) | 257 (46.1) | 293 (52.6) | 295 (53.0) | .06c |
| Race | ||||||
| White | 468 (84.0) | 459 (82.3) | 452 (81.1) | 472 (84.7) | 457 (82.0) | .12d |
| Black | 17 (3.1) | 33 (5.9) | 29 (5.2) | 36 (6.5) | 37 (6.6) | |
| Asian/Pacific Islander | 70 (12.6) | 63 (11.3) | 72 (12.9) | 46 (8.3) | 62 (11.1) | |
| Other/unknown | 2 (0.4) | 3 (0.5) | 4 (0.7) | 3 (0.5) | 1 (0.2) | |
| Socioeconomic status | ||||||
| Low (first quintile) | 84 (15.1) | 100 (17.9) | 116 (20.8) | 104 (18.7) | 127 (22.8) | .001c |
| Low to middle (second quintile) | 79 (14.2) | 111 (19.9) | 112 (20.1) | 116 (20.8) | 109 (19.6) | |
| Middle (third quintile) | 123 (22.1) | 100 (17.9) | 110 (19.7) | 112 (20.1) | 100 (18.0) | |
| Middle to high (fourth quintile) | 112 (20.1) | 104 (18.6) | 103 (18.5) | 109 (19.6) | 117 (21.0) | |
| High (fifth quintile) | 159 (28.5) | 143 (25.6) | 116 (20.8) | 116 (20.8) | 104 (18.7) | |
| Elixhauser comorbidity index, mean (SD)e | 10.5 (6.0) | 12.4 (7.6) | 13.7 (8.1) | 15.2 (9.5) | 17.9 (10.9) | <.001b |
| T category | ||||||
| T1 | 61 (11.0) | 29 (5.2) | 39 (7.0) | 41 (7.4) | 34 (6.1) | <.001c |
| T2 | 101 (18.1) | 108 (19.4) | 79 (14.2) | 81 (14.5) | 66 (11.8) | |
| T3 | 395 (70.9) | 421 (75.4) | 439 (78.8) | 435 (78.1) | 457 (82.0) | |
| N category | ||||||
| N0 | 236 (42.4) | 203 (36.4) | 218 (39.1) | 195 (35.0) | 202 (36.3) | .04d |
| N1 | 319 (57.3) | 354 (63.4) | 339 (60.9) | 358 (64.3) | 355 (63.7) | |
| NX | 2 (0.4) | 1 (0.2) | 0 | 4 (0.7) | 0 | |
| Stage | ||||||
| I | 118 (21.2) | 79 (14.2) | 67 (12.0) | 70 (12.6) | 65 (11.7) | <.001c |
| II | 439 (78.8) | 479 (85.8) | 490 (88.0) | 487 (87.4) | 492 (88.3) | |
| Grade | ||||||
| Well differentiated | 52 (9.3) | 60 (10.8) | 66 (11.8) | 69 (12.4) | 48 (8.6) | .41c |
| Moderately differentiated | 284 (51.0) | 275 (49.3) | 276 (49.6) | 264 (47.4) | 274 (49.2) | |
| Poorly differentiated or undifferentiated | 186 (33.4) | 197 (35.3) | 189 (33.9) | 189 (33.9) | 188 (33.8) | |
| Unknown | 35 (6.3) | 26 (4.7) | 26 (4.7) | 35 (6.3) | 47 (8.4) | |
| Pancreatic resection | ||||||
| Pancreaticoduodenectomy | 310 (55.7) | 459 (82.3) | 480 (86.2) | 474 (85.1) | 484 (86.9) | <.001c |
| Distal pancreatectomy | 197 (35.4) | 68 (12.2) | 35 (6.3) | 49 (8.8) | 38 (6.8) | |
| Total pancreatectomy | 17 (3.1) | 7 (1.3) | 26 (4.7) | 24 (4.3) | 24 (4.3) | |
| Other pancreatectomy | 33 (5.9) | 24 (4.3) | 16 (2.9) | 10 (1.8) | 11 (2.0) | |
| Chemotherapy | ||||||
| None | 204 (36.6) | 165 (29.6) | 193 (34.6) | 205 (36.8) | 303 (54.4) | <.001c |
| Preoperative | 14 (2.5) | 15 (2.7) | 16 (2.9) | 25 (4.5) | 19 (3.4) | |
| Postoperative | 259 (46.5) | 286 (51.3) | 274 (49.2) | 247 (44.3) | 172 (30.9) | |
| Sequence unknown/other | 80 (14.4) | 92 (16.5) | 74 (13.3) | 80 (14.4) | 63 (11.3) | |
| Radiotherapy | 176 (31.6) | 201 (36.0) | 209 (37.5) | 168 (30.2) | 120 (21.5) | <.001c |
| NCI-designated cancer center | 247 (44.3) | 235 (42.1) | 210 (37.7) | 198 (35.5) | 237 (42.5) | .01c |
| Teaching hospital | 250 (44.9) | 291 (52.2) | 291 (52.2) | 286 (51.3) | 310 (55.7) | .008c |
| High-volume centerf | 245 (44.0) | 252 (45.2) | 255 (45.8) | 265 (47.6) | 280 (50.3) | .25c |
| Survival, median (IQR), mo | 26 (12-61) | 24 (12-42) | 22 (12-43) | 17 (10-33) | 13 (6-31) | <.001g |
| Length of stay, median (IQR), d | 8 (7-10) | 10 (9-13) | 13 (10-15) | 16 (11-20) | 24 (18-34) | <.001g |
| Complication within 30 d | 62 (11.1) | 111 (19.9) | 182 (32.7) | 266 (47.8) | 416 (74.7) | <.001c |
| Readmission within 30 d | 36 (6.5) | 54 (9.7) | 103 (18.5) | 146 (26.2) | 226 (40.6) | <.001c |
| In-hospital death | 8 (1.4) | 7 (1.3) | 7 (1.3) | 19 (3.4) | 63 (11.3) | <.001c |
Abbreviations: IQR, interquartile range; NCI, National Cancer Institute.
a
Unless otherwise indicated, data are expressed as number (percentage) of patients. Percentages have been rounded and may not total 100. Low indicates less than $30 007; low to intermediate, $30 007 to $40 674; intermediate, $40 675 to $53 970; intermediate to high, $53 971 to $76 695; and high, greater than $76 995.
b
Calculated using analysis of variance.
c
Calculated using χ2 test.
d
Calculated using Fisher exact text.
e
Scores range from −11 to 62, with higher scores indicating a greater number of comorbidities.
f
Indicates 20 or more cases annually.
g
Calculated using Kruskal-Wallis test.