Predictors of 30-day readmission following pancreatic surgery: A retrospective review

Amodu, Leo; Alexis, Jamil; Soleiman, Aron; Akerman, Meredith; Addison, Poppy; Iurcotta, Toni; Rilo, Horacio

doi:10.1016/j.hbpd.2018.04.002

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…In a French nationwide study of more than 22,000 patients, we observed that the rate of unplanned readmission after pancreatectomy was nearly 40% within 6 months. This finding is comparable to those of previous studies, wherein the readmission rate ranged from 15% to 38% 29,30 . Only a few studies have focused on the 6-month readmission rate and associated risk factors.…”

Section: Discussionsupporting

confidence: 89%

Study of Risk Factors for Readmission After Pancreatectomy for Cancer

et al. 2023

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Objective: To identify the factors associated with readmission after pancreatectomy for cancer and to assess their impact on the 1-year mortality in a French multicentric population. Background: Pancreatectomy is a complex procedure with high morbidity that increases the length of hospital stay and jeopardizes survival. Hospital readmissions lead to increased health system costs, making this a topic of great interest. Methods: Data collected from patients who underwent pancreatectomy for cancer between 2011 and 2019 were extracted from a French national medico-administrative database. A descriptive analysis was conducted to evaluate the association of baseline variables, including age, sex, liverrelated comorbidities, Charlson Comorbidity Index, tumor localization, and use of neoadjuvant therapy, along with hospital type and volume, with readmission status. Centers were divided into low and high volumes according to the cutoff of 26 cases/year. Logistic regression models were developed to determine whether the identified bivariate associations persisted after adjusting for the patient characteristics. The mortality rates during readmission and at 1 year postoperatively were also determined. Results: Of 22,935 patients who underwent pancreatectomy, 9129 (39.3%) were readmitted within 6 months. Readmission rates by year did not vary over the study period, and mean readmissions occurred within 20 days after discharge. Multivariate analysis showed that male sex [odds ratio (OR) = 1.12], age > 70 years (OR = 1.16), comorbidities (OR = 1.21), distal pancreatectomy (OR = 1.11), and major postoperative complications (OR = 1.37) were predictors of readmission. Interestingly, readmission and surgery in low-volume centers increased the risk of death at 1 year by a factor of 2.15 [(2.01-2.31), P < 0.001] and 1.31 [(1.17-1.47), P < 0.001], respectively.Conclusions: Readmission after pancreatectomy for cancer is high with an increased rate of 1-year mortality.

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Section: Discussionsupporting

confidence: 89%

Study of Risk Factors for Readmission After Pancreatectomy for Cancer

et al. 2023

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“…There have been various studies on unplanned readmissions in general surgical patients [456]. Recently studies have also been carried out to see readmission rates in patients undergoing urologic surgeries [789].…”

Section: Introductionmentioning

confidence: 99%

Unplanned 30-day readmission rates in patients undergoing endo-urological surgeries for upper urinary tract calculi

et al. 2018

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PurposeTo see the 30-day unplanned readmission rates in patients underdoing endo-urological surgeries for upper urinary tract calculi we conducted this retrospective study at King George's Medical University, Lucknow, India. Unplanned readmissions not only add to healthcare costs but also are bothersome for the patients. There are many studies on 30-day unplanned readmissions in general surgical patients. Although similar studies have been done in certain urological procedures, no study has reported readmission rates or its risk factors in patients undergoing surgeries for upper urinary tract calculi.Materials and MethodsWe retrospectively reviewed our prospectively maintained database from 1st January 2009 to 31st December 2017, for the patients who underwent endo-urological procedures for upper urinary tract calculi and identified the patients who were re-admitted within 30 days of discharge.ResultsOut of the total 3,209 patients undergoing endo-urological procedures for upper urinary tract calculi 56 were re-admitted. The readmission rate was 1.74% over the study period. The most common etiology for readmission was sepsis followed by hematuria. The significant risk factors for readmission in bivariate analysis included male gender, age >65 years, current smoking, chronic obstructive pulmonary disease, diabetes mellitus, bleeding disorder, prior cardiac disease, and American Society of Anesthesiologists (ASA) class ≥3. In multivariate risk adjusted logistic regression analysis ASA class ≥3 was the only independent risk factor for readmission.ConclusionsThe readmission rates in endo-urological procedures for urolithiasis are less compared to other procedures. ASA class ≥3 is the most important independent predictor of unplanned 30-day readmissions.

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“…In a separate study using the NISQIP dataset, Lyu et al similarly reported that complications such as the need for a transfusion and post-operative infection increased the likelihood of readmission. 3 In the current study, we noted that socioeconomic status was also associated with risk of readmission as patients covered by Medicaid and poor patients with no charge had higher risk of readmission. In addition, we noted that the actual causes of readmission were different between HQ and LQ hospitals.…”

Section: Discussionmentioning

confidence: 51%

“…3 As such, the actual burden of readmission has likely been underestimated in most previous studies. [2][3][4][17][18][19][20][21] The current study utilized the NRD, which allowed for the characterization of outcomes and cumulative costs of both the index and non-index readmission following pancreatic resection. Utilizing this large national readmission database, population level estimates were obtained that allowed for a more generalized assessment of hospital quality relative to readmission among hospitals in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…Most previous studies have been limited, however, to reports on only outcomes and predictors of readmissions. [1][2][3][4][5][6] While these reports are helpful in quantifying the overall burden of morbidity, readmission as a metric of hospital quality to distinguish between high quality (HQ) and low quality hospitals (LQ) has not been examined. In addition, population level data on cause specific costs of readmission are very limited and, to our knowledge, no previous study has specifically examined cost-effectiveness utilizing readmission as a measure of quality and compared HQ versus LQ hospitals.…”

Section: Introductionmentioning

confidence: 99%

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