Risk of 90-day mortality after DP-CAR
Calculate the preoperative risk of 90-day mortality after distal pancreatectomy with celiac axis resection (DP-CAR) for pancreatic cancer. 
Research authors: Sjors Klompmaker, Niek A Peters, Jony van Hilst, Claudio Bassi, Ugo Boggi, Olivier R Busch, Willem Niesen, Thomas M van Gulik, Ammar A Javed, Jorg Kleeff, Manabu Kawai, Mickael Lesurtel, Carlo Lombardo, A James Moser, Ken-ichi Okada, Irinel Popescu, Raj Prasad, Roberto Salvia, Alain Sauvanet, Christian Sturesson, Matthew J Weiss, Herbert J Zeh, Amer H Zureikat, Hiroki Yamaue, Christopher L Wolfgang, Melissa E Hogg, Marc G Besselink, the E-AHPBA DP-CAR study group
Details Formula Study characteristics Files & References
Model author
Model ID
Revision date
MeSH terms
  • Pancreatic Cancer
  • Pancreatic Disease
  • Pancreas
  • Surgery, General
  • Minimally Invasive Surgery
  • Model type
    Logistic regression (Calculation)
    No Formula defined yet
    Condition Formula

    Additional information


    BACKGROUND: Distal pancreatectomy with celiac axis resection (DP-CAR) is a treatment option for selected patients with pancreatic cancer involving the celiac axis. A recent multicenter European study reported a 90-day mortality rate of 16%, highlighting the importance of patient selection. The authors constructed a risk score to predict 90-day mortality and assessed oncologic outcomes.

    METHODS: This multicenter retrospective cohort study investigated patients undergoing DP-CAR at 20 European centers from 12 countries (model design 2000–2016) and three very-high-volume international centers in the United States and Japan (model validation 2004–2017). The model was first designed in 1661 distal pancreatectomy patiens. The DP-CAR risk score was based on these model coefficents. The area under receiver operator curve (AUC) and calibration plots were used for validation. Secondary outcomes included resection margin status, adjuvant therapy, and survival.

    RESULTS: For 191 DP-CAR patients, the 90-day mortality rate was 5.5% (95 confidence interval [CI], 2.2–11%) at 5 high-volume (≥ 1 DP-CAR/year) and 18% (95 CI, 9–30%) at 18 low-volume DP-CAR centers (P = 0.015). A risk score with age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, multivisceral resection, open versus minimally invasive surgery, and low- versus high-volume center performed well in both the design and validation cohorts (AUC, 0.79 vs 0.74; P = 0.642). For 174 patients with pancreatic ductal adenocarcinoma, the R0 resection rate was 60%, neoadjuvant and adjuvant therapies were applied for respectively 69% and 67% of the patients, and the median overall survival period was 19 months (95 CI, 15–25 months).

    CONCLUSIONS: When performed for selected patients at high-volume centers, DP-CAR is associated with acceptable 90-day mortality and overall survival. The authors propose a 90-day mortality risk score to improve patient selection and outcomes, with DP-CAR volume as the dominant predictor.

    Study Population

    Total population size: 191

    Additional characteristics

    No additional characteristics defined
    Risk of 90-day mortality after DP-CAR
    Refer to Intended Use for instructions before use
    Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands

    Related files

    No related files available
    Notes are only visible in the result download and will not be saved by Evidencio

    The predicted risk of 90-day mortality is:

    {{ resultSubheader }}
    {{ chart.title }}

    Outcome stratification

    Result interval {{ additionalResult.min }} to {{ additionalResult.max }}

    Conditional information

    {{ file.classification }}

    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

    Please enter a comment of rating
    Comments are visible to anyone

    Model feedback

    No feedback yet 1 Comment {{ model.comments.length }} Comments
    Not rated | On {{ comment.created_at }} {{ comment.user.username }} a no longer registered author wrote:

    Please sign in to enable Evidencio print features

    In order to use the Evidencio print features, you need to be logged in.
    If you don't have an Evidencio Community Account you can create your free personal account at:


    Printed results - Examples {{ new Date().toLocaleString() }}

    Evidencio Community Account Benefits

    With an Evidencio Community account you can:

    • Create and publish your own prediction models.
    • Share your prediction models with your colleagues, research group, organization or the world.
    • Review and provide feedback on models that have been shared with you.
    • Validate your models and validate models from other users.
    • Find models based on Title, Keyword, Author, Institute, or MeSH classification.
    • Use and save prediction models and their data.
    • Use patient specific protocols and guidelines based on sequential models and decision trees.
    • Stay up-to-date with new models in your field as they are published.
    • Create your own lists of favorite models and topics.

    A personal Evidencio account is free, with no strings attached!
    Join us and help create clarity, transparency, and efficiency in the creation, validation, and use of medical prediction models.

    Disclaimer: Calculations alone should never dictate patient care, and are no substitute for professional judgement.