Highlight
- Identification of six modifiable hospital-level factors significantly linked to lower 90-day mortality after pancreas surgery across 60 countries.
- Development of a Hospital Resource Index (HRI) combining these factors, demonstrating cumulative protective effects independent of surgical volume.
- Hospitals possessing all six HRI components show a 54% reduction in postoperative mortality compared to those lacking these resources.
- Findings provide actionable targets for infrastructure and process improvements to enhance surgical outcomes globally beyond centralization policies.
