National Trends in Readmission and Resource Utilization After Pancreatectomy in the United States
| Autor: | Yas Sanaiha, Esteban Aguayo, Ashley Huynh, Peyman Benharash, Vishal Dobaria, Sohail Sareh, James W. Antonios, Jonathan C. King |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Patient Readmission Pancreatic surgery 03 medical and health sciences Pancreatectomy 0302 clinical medicine medicine Humans National trends Retrospective Studies business.industry General surgery Middle Aged Patient Acceptance of Health Care United States 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Postsurgical complications business Index hospitalization Resource utilization |
| Zdroj: | Journal of Surgical Research. 255:304-310 |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2020.04.037 |
| Popis: | Pancreatectomy is a complex operation that has been associated with excess morbidity and mortality. Although acute index outcomes have been characterized, there are limited data available on nonelective readmission after pancreatic surgery. We sought to identify factors associated with 30-day and 30- to 90-day readmission after pancreatectomy.We utilized the National Readmissions Database between 2010 and 2016 to identify adults who underwent a pancreatectomy. The primary outcomes were 30-day (30DR) and 30- to 90-day (90DR) readmission. Secondary outcomes included nonelective readmission trends, diagnosis, length of stay, charges, and mortality.Of an estimated 130,267 subjects undergoing pancreatectomy, 97% survived index hospitalization. Eighteen percent of patients had nonelective 30DR while 5.6% experienced 90DR. Readmission at the two time points remained stable during the study period. After adjusting for institution, pancreatectomy volume, mortality (2.0% versus 4.9%, P 0.001), 30DR length of stay (7.3 d versus 7.8 d, P 0.001), and 90DR rates (6.9% versus 8.1%, P = 0.003) were significantly decreased at high-volume pancreatectomy centers compared to low-volume hospitals. Discharge to a skilled nursing facility (AOR: 1.52) or with home health care (AOR: 1.2) was associated with 30DR (P 0.001). Patients undergoing total pancreatectomy (AOR: 1.3) or those with a substance use disorder (AOR: 1.4) among others were associated with 90DR (P ≤ 0.01).Readmissions are common and costly after pancreatectomy. Approximately 20% of patients experience readmission within 30 d. 30DR and 90DR rates remained stable during the study. Pancreatectomy at a high-volume center was associated with decreased mortality and 90DR. The present analysis confirms associations between pancreatectomy volume, postsurgical complications, comorbidities, and readmission. |
| Databáze: | OpenAIRE |
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