Key result
Male sex, prolonged stay, and anemia linked to increased 30-day readmission in ~20% of pancreatectomy patients.
Why the study?
Readmissions after pancreatectomy lead to increased costs, morbidity, and mortality, and factors associated with readmission were not well defined.
What factors are associated with 30-day readmission after pancreatectomy for malignancy?
Cohort (n=4,262)
Yes
What factors are associated with 30-day readmission after pancreatectomy for malignancy?
Readmission after pancreatectomy for malignancy is common (19.8% at 30 days) and associated with specific demographic and clinical factors.
Certain patient and discharge factors were associated with higher readmission risk after pancreatectomy; leaves open whether targeted interventions reduce rates.
BACKGROUND: Pancreatectomy is a complex operation with a historic readmission rate of approximately 20%. Hospital readmissions lead to increased patient and health system costs, morbidity, and mortality making them a topic of great interest. The objective of this study was to identify factors associated with readmission after pancreatectomy in order to target areas for improvement. METHODS: Pancreatectomy procedures for malignancy in adults from 2005 to 2011 were identified in the California State Inpatient Database. Descriptive analysis was conducted to evaluate the association between baseline variables and readmission status. Logistic regression models were developed to determine whether the bivariate associations identified persisted after adjusting for patient characteristics. RESULTS: Of the 4262 patients who underwent a pancreatectomy, 843 (19.8%) were readmitted within 30 days. Readmission rates by year did not vary over the study period. Results from multivariable analysis showed that males, Hispanics, Medicare recipients, patients with an initial length of stay >11 days, patients who were discharged to a skilled nursing facility, and those with chronic anemia were more likely to be readmitted compared to those without these characteristics. The majority of readmissions occurred within 15 days after discharge. CONCLUSIONS: Readmissions after pancreatectomy are multifactorial. Preoperative optimization, minimizing postoperative complications, and assuring patients have been evaluated by a multidisciplinary team may reduce the readmission rate.
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Hue et al. (2020) conducted a cohort in Pancreatectomy for malignancy (n=4,262). Patient and clinical characteristics (e.g., male sex, Hispanic ethnicity, Medicare, LOS >11 days) vs. Patients without these characteristics was evaluated on Readmission within 30 days. Male sex, Hispanic ethnicity, Medicare, LOS >11 days, SNF discharge, and chronic anemia were associated with increased risk of 30-day readmission, which occurred in 19.8% of pancreatectomy patients.
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