Early hospital readmission for gastrointestinal-related complications predicts long-term mortality after pancreatectomy

Abstract

BACKGROUND The purpose of this study was to investigate the prognostic significance of early (30-day) hospital readmission (EHR) on mortality after pancreatectomy. METHODS Using a prospectively collected institutional database linked with a statewide dataset, we evaluated the association between EHR and overall mortality in all patients undergoing pancreatectomy at our tertiary institution (2005 to 2010). RESULTS Of 595 pancreatectomy patients, EHR occurred in 21.5%. Overall mortality was 29.4% (median follow-up 22.7 months). Patients with EHR had decreased survival compared with those who were not readmitted (P = .011). On multivariate analysis adjusting for baseline group differences, EHR for gastrointestinal-related complications was a significant independent predictor of mortality (hazard ratio 2.30, P = .001). CONCLUSIONS In addition to known risk factors, 30-day readmission for gastrointestinal-related complications following pancreatectomy independently predicts increased mortality. Additional studies are necessary to identify surgical, medical, and social factors contributing to EHR, as well as interventions aimed at decreasing postpancreatectomy morbidity and mortality.

A National Assessment of Optimal Oncologic Surgery for Distal Pancreatic Adenocarcinomas

“…[22][23][24] Although postoperative complications were not included in our definition of optimal surgery, hospital length of stay ≤7 days and absence of 30-day readmission serve as surrogates markers for complications that often drive lengthy hospitalizations and readmissions. 25,26 Lastly, patients in the optimal cohort appropriately received systemic chemotherapy, which aligns with current National Comprehensive Cancer Network guidelines. 27 Systemic therapy improves disease-free and overall survival for pancreatic cancer patients, and adherence to cancer care guidelines is therefore crucial for optimizing outcomes.…”

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

“…Though this parameter has not been considered in majority of the studies, some authors have found it to be significant. 11,18 This is probably due to the fact that hypoproteinemia predisposes patients to increased risk of infections because of poor immunity. Moreover, hypoproteinemia leads to poor wound healing thus causing increased risk of anastomotic leak as well as wound dehiscence.…”

Effect of Enhanced Recovery After Surgery program on hospital stay and 90-day readmission after pancreaticoduodenectomy: a single, tertiary center experience in Korea

“…The advantage of ERAS against the risk of readmission remains unclear in patients undergoing PD, especially with its high risk of morbidity because full postoperative recovery compared to other gastrointestinal surgeries is known to take longer [12]. Unintended readmission after PD, that is reported to increase hospital cost for patients as well as morbidity and mortality, is considered to be a quality metric for surgery [13]. Therefore, it is important to evaluate the association between ERAS and readmission and to identify the risk factors for the same.…”