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Readmission incidence and associated factors after a hepatic resection at a major hepato-pancreatico-biliary academic centre.
HPB (Oxford) 2014; 16(11):972-8H

Abstract

BACKGROUND

Reducing readmission is a key quality improvement target for policymakers. The purpose of the present study was to define incidence and identify factors associated with readmission after a hepatic resection.

METHODS

Thirty-day readmission after discharge and factors associated with a higher risk of readmission were examined among patients undergoing a hepatic resection at Johns Hopkins Hospital between 2008 and 2012.

RESULTS

Among the 338 patients, the median age was 57.9 years and 173 (51.2%) were men. Indications for surgery included colorectal cancer liver metastasis (38.2%), primary hepatic tumours (25.7%) and benign disease (3.3%). Surgical resection consisted of less than a hemi-hepatectomy in the majority of patients (n = 224, 66.3%). The median index hospitalization length-of-stay (LOS) was 5 days; 68.7% patients experienced at least one inpatient complication. Overall 30-day readmission was 14.2% (n = 48). The majority of readmitted patients (n = 46, 95.8%) had a complication prior to readmission. The median LOS for readmission was 4 [interquartile range (IQR) 2-6] days. On multivariable analysis, the strongest independent predictor of readmission was the presence of a major complication [odds ratio (OR) 5.30, 95% confidence interval (CI) 2.38-11.78, P < 0.001].

CONCLUSIONS

Readmission after a hepatic resection occurs in approximately one out of every seven patients. Patients who experience a post-operative complication are greater than five times more likely to be readmitted. Prospective studies are needed to evaluate methods to reduce unplanned readmissions.

Authors+Show Affiliations

Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24712690

Citation

Spolverato, Gaya, et al. "Readmission Incidence and Associated Factors After a Hepatic Resection at a Major Hepato-pancreatico-biliary Academic Centre." HPB : the Official Journal of the International Hepato Pancreato Biliary Association, vol. 16, no. 11, 2014, pp. 972-8.
Spolverato G, Ejaz A, Kim Y, et al. Readmission incidence and associated factors after a hepatic resection at a major hepato-pancreatico-biliary academic centre. HPB (Oxford). 2014;16(11):972-8.
Spolverato, G., Ejaz, A., Kim, Y., Weiss, M., Wolfgang, C. L., Hirose, K., & Pawlik, T. M. (2014). Readmission incidence and associated factors after a hepatic resection at a major hepato-pancreatico-biliary academic centre. HPB : the Official Journal of the International Hepato Pancreato Biliary Association, 16(11), pp. 972-8. doi:10.1111/hpb.12262.
Spolverato G, et al. Readmission Incidence and Associated Factors After a Hepatic Resection at a Major Hepato-pancreatico-biliary Academic Centre. HPB (Oxford). 2014;16(11):972-8. PubMed PMID: 24712690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Readmission incidence and associated factors after a hepatic resection at a major hepato-pancreatico-biliary academic centre. AU - Spolverato,Gaya, AU - Ejaz,Aslam, AU - Kim,Yuhree, AU - Weiss,Mattew, AU - Wolfgang,Christopher L, AU - Hirose,Kenzo, AU - Pawlik,Timothy M, Y1 - 2014/04/09/ PY - 2014/02/10/received PY - 2014/03/05/accepted PY - 2014/4/10/entrez PY - 2014/4/10/pubmed PY - 2015/6/26/medline SP - 972 EP - 8 JF - HPB : the official journal of the International Hepato Pancreato Biliary Association JO - HPB (Oxford) VL - 16 IS - 11 N2 - BACKGROUND: Reducing readmission is a key quality improvement target for policymakers. The purpose of the present study was to define incidence and identify factors associated with readmission after a hepatic resection. METHODS: Thirty-day readmission after discharge and factors associated with a higher risk of readmission were examined among patients undergoing a hepatic resection at Johns Hopkins Hospital between 2008 and 2012. RESULTS: Among the 338 patients, the median age was 57.9 years and 173 (51.2%) were men. Indications for surgery included colorectal cancer liver metastasis (38.2%), primary hepatic tumours (25.7%) and benign disease (3.3%). Surgical resection consisted of less than a hemi-hepatectomy in the majority of patients (n = 224, 66.3%). The median index hospitalization length-of-stay (LOS) was 5 days; 68.7% patients experienced at least one inpatient complication. Overall 30-day readmission was 14.2% (n = 48). The majority of readmitted patients (n = 46, 95.8%) had a complication prior to readmission. The median LOS for readmission was 4 [interquartile range (IQR) 2-6] days. On multivariable analysis, the strongest independent predictor of readmission was the presence of a major complication [odds ratio (OR) 5.30, 95% confidence interval (CI) 2.38-11.78, P < 0.001]. CONCLUSIONS: Readmission after a hepatic resection occurs in approximately one out of every seven patients. Patients who experience a post-operative complication are greater than five times more likely to be readmitted. Prospective studies are needed to evaluate methods to reduce unplanned readmissions. SN - 1477-2574 UR - https://www.unboundmedicine.com/medline/citation/24712690/Readmission_incidence_and_associated_factors_after_a_hepatic_resection_at_a_major_hepato_pancreatico_biliary_academic_centre_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1365-182X(15)31513-6 DB - PRIME DP - Unbound Medicine ER -