Risk factors for 30-day hospital readmission after radical gastrectomy: a single-center retrospective study

Asaoka, Raito; Kawamura, Taiichi; Makuuchi, Rie; Irino, Tomoyuki; Takeda, Yutaka; Bando, Etsuro; Terashima, Masanori

doi:10.1007/s10120-018-0856-4

Cited by 10 publications

(10 citation statements)

References 38 publications

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“…As demonstrated in Tables 1 and 2 , the length of hospital stay in IAI patients was significantly longer in terms of short-term prognosis. Studies have revealed that intra-abdominal abscess is one of the common causes of readmission ( 20 ), severely affecting patients’ prognosis and quality of life. According to the Extended Clavien-Dindo classification of intra-abdominal infection ( 21 ), 1 case (2.9%) reached II, 30 cases (88.2%) reached IIIa, 3 cases (8.9%) reached IIIb stage.…”

Section: Resultsmentioning

confidence: 99%

Nomogram of intra-abdominal infection after surgery in patients with gastric cancer: A retrospective study

et al. 2022

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BackgroundSurgical resection is still the primary way to treat gastric cancer. Therefore, postoperative complications such as IAI (intra-abdominal infection) are major problems that front-line clinical workers should pay special attention to. This article was to build and validate IAI’s RF (regression function) model. Furthermore, it analyzed the prognosis in patients with IAI after surgery for stomach cancer. The above two points are our advantages, which were not involved in previous studies.MethodsThe data of this study was divided into two parts, the training data set and the validation data set. The training data for this article were from the patients treated surgically with gastric cancer in our center from December 2015 to February 2017. We examined IAI’s morbidity, etiological characteristics, and prognosis in the training data set. Univariate and multivariate logistic regression analyses were used to screen risk factors, establish an RF model and create a nomogram. Data from January to March 2021 were used to validate the accuracy of the RF model.ResultsThe incidence of IAI was 7.2%. The independent risk factors for IAI were hypertension (Odds Ratio [OR] = 3.408, P = 0.001), history of abdominal surgery (OR = 2.609, P = 0.041), combined organ excision (OR = 4.123, P = 0.010), and operation time ≥240 min (OR = 3.091, P = 0.005). In the training data set and validation data set, the area under the ROC curve of IAI predicted by the RF model was 0.745 ± 0.048 (P<0.001) and 0.736 ± 0.069 (P=0.003), respectively. In addition, IAI significantly extended the length of hospital stay but had little impact on survival.ConclusionsPatients with hypertension, combined organ excision, a history of abdominal surgery, and a surgical duration of 240 min or more are prone to IAI, and the RF model may help to identify them.

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Section: Resultsmentioning

confidence: 99%

Nomogram of intra-abdominal infection after surgery in patients with gastric cancer: A retrospective study

et al. 2022

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“…Additionally, it is notable that only 2 studies reported a relationship between the resection type and 30-day readmission. Asaoka et al [ 15 ] reported that laparoscopic surgery (OR 2.25; 95% CI: 1.17–4.31; P = .015) was an independent risk factor for postoperative readmission, whereas no significant difference (OR 2.039; 95% CI: 0.727–5.722; P = .168) was detected in the study performed by Zhuang et al [ 17 ]…”

Section: Resultsmentioning

confidence: 99%

“…In the presented study, the readmission rate at 30 days postgastrectomy was 11.7%. The reported readmission rate was diverse among included studies; the incidence rate was 2.7%, 2.9%, and 7.2% in the 3 studies from East Asia [ 15 – 17 ] but was 14.2%, 14.6%, and 16.5% in the other 3 studies from the United States. [ 12 – 14 ] Reasons for the different readmission rates between these studies are unclear.…”

Section: Discussionmentioning

confidence: 99%

“…[ 31 ] In the present study, we found that the intolerability of oral intake was the most common reason for postoperative readmission (up to 30.8%). [ 12 , 13 , 15 – 17 ] Postoperative abdominal pain, eating disorders due to fear, gastrointestinal functional disorders, and incomplete obstruction are likely to result from the intolerability of oral intake, which is specific for operations of the esophagus and stomach. We also observed that the diversity of readmission causes was different among studies.…”

Section: Discussionmentioning

confidence: 99%

“…[ 38 , 39 ] However, there is no analysis about the relationship between robotic surgery and postoperative readmission of those 6 included studies. Asaoka et al [ 15 ] mentioned that they excluded the robotic surgery and the other 5 studies did not mention whether included robotic surgery in the analysis. [ 12 – 14 , 16 , 17 ] Besides, there is limited studies compared the postoperative readmission after robotic gastric cancer surgery with laparoscopic or open surgery.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of the postoperative 30-day readmission of gastric cancer surgery after discharge

Zhang

et al. 2019

Medicine

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Background:Readmission is a common postoperative adverse event. This study aimed to analyze potential risk factors for the incidence of postoperative 30-day readmission after discharge for gastric cancer patients with surgical treatment.Methods:Those studies that reported the risk factors of gastric cancer patients who have a postoperative 30-day readmission were identified systematically from the PubMed, Cochrane, and Embase databases through July 2018. A systematic review and meta-analysis was performed to estimate the risk factors of postoperative 30-day readmission after gastric cancer surgery.Results:Ultimately, 6 studies with 12,586 gastric cancer patients were included in the present study. There were 1473 (11.7%) patients who had postoperative 30-day readmission and 12,586 (88.3%) patients without 30-day postoperative readmission. A greater proportion of the readmission group had cardiovascular comorbidity (P < .001), pulmonary comorbidity (P < .001), and diabetes mellitus (P = .020) than the nonreadmission group. Furthermore, more patients in the readmission group had total gastrectomy (P < .001), combined organ resection (P < .001) and postoperative complications (P < .001) than did patients in the nonreadmission group. Nonhome discharge (odds ratio [OR] 1.580, P = .002), diabetes mellitus (OR 1.181, P = .044), postoperative complications (OR 2.656, P = .006), total gastrectomy (OR 2.242, P < .001), and combined organ resection (OR 1.534, P < .001) were independent risk factors for postoperative readmission.Conclusion:Postoperative readmission is influenced by the synthetic action of preparative, intraoperative, and postoperative factors, such as diabetes mellitus, total gastrectomy, combined organ resection, nonhome discharge, and postoperative complications. Extra attention should be paid to those patients with high risk factors during the postoperative follow-up and recovery periods.

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Implementation of the Robocare nursing model for patients undergoing da Vinci robot-assisted radical gastrectomy for gastric cancer

Wang,

Chen,

Tang

2024

J Robotic Surg

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Risk factors for 30-day hospital readmission after radical gastrectomy: a single-center retrospective study

Abstract: CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.

Cited by 10 publications

References 38 publications

Nomogram of intra-abdominal infection after surgery in patients with gastric cancer: A retrospective study

Nomogram of intra-abdominal infection after surgery in patients with gastric cancer: A retrospective study

Risk factors of the postoperative 30-day readmission of gastric cancer surgery after discharge

Implementation of the Robocare nursing model for patients undergoing da Vinci robot-assisted radical gastrectomy for gastric cancer

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