Key result
Any postoperative complications strongly predicted 30-day readmission after pancreatic resection (OR 2.22; 95% CI 1.55-3.18), with an overall readmission rate of 19.1%.
Why the study?
What are the common reasons and risk factors for 30-day readmission after pancreatic resection?
Meta-Analysis
What are the common reasons and risk factors for 30-day readmission after pancreatic resection?
Odds Ratio: 2.22 (95% CI 1.55–3.18)
Readmission after pancreatic resection is common (19.1%) and largely driven by infectious complications and gastrointestinal disorders, highlighting the need for targeted outpatient follow-up.
May inform targeted post-discharge monitoring for infection and nutrition; leaves open whether interventions reduce readmissions after pancreatectomy.
OBJECTIVE: The aim of this study was to identify and compare common reasons and risk factors for 30-day readmission after pancreatic resection. BACKGROUND: Hospital readmission after pancreatic resection is common and costly. Many studies have evaluated this problem and numerous discrepancies exist regarding the primary reasons and risk factors for readmission. METHODS: Multiple electronic databases were searched from 2002 to 2016, and 15 relevant articles identified. Overall readmission rate was calculated from individual study estimates using a random-effects model. Study data were combined and overall estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each risk factor. Multivariable data were qualitatively synthesized. RESULTS: The overall 30-day readmission rate was 19.1% (95% CI 17.4-20.7) across all studies. Infectious complications and gastrointestinal disorders, such as failure to thrive and delayed gastric emptying, together accounted for 58.9% of all readmissions. Demographic factors did not predict readmission. Heart disease (OR 1.37, 95% CI 1.12-1.67), hypertension (OR 1.44, 95% CI 1.09-1.91), and intraoperative blood transfusion (OR 1.45, 95% CI 1.15-1.83) were weak predictors of readmission, while any postoperative complications (OR 2.22, 95% CI 1.55-3.18) or severe complications (OR 2.84, 95% CI 1.65-4.89) were stronger predictors. CONCLUSIONS: Readmission after pancreatic resection is common and can largely be attributed to infectious complications and inability to maintain adequate hydration and nutrition. Focus on outpatient resources and follow-up to address these issues will prove valuable in reducing readmissions.
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Fisher et al. (2017) conducted a meta-analysis in Pancreatic resection. Any postoperative complications vs. No postoperative complications was evaluated on 30-day readmission (OR 2.22, 95% CI 1.55-3.18). Any postoperative complications strongly predicted 30-day readmission after pancreatic resection (OR 2.22; 95% CI 1.55-3.18), with an overall readmission rate of 19.1%.
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