Early hospital readmission for gastrointestinal-related complications predicts long-term mortality after pancreatectomy

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• 作者：Caitlin W. Hicks ; M.D. ; M.S. ; Jeffrey J. Tosoian ; M.D. ; M.P.H. ; Rebecca Craig-Schapiro ; M.D. ; Ph.D. ; Vicente Valero III ; M.D. ; John L. Cameron ; M.D. ; Frederic E. Eckhauser ; M.D. ; Kenzo Hirose ; M.D. ; Martin A. Makary ; M.D. ; M.P.H. ; Timothy M. Pawlik ; M.D. ; M.P.H. ; Ph.D. ; Nita Ahuja ; M.D. ; Matthew J. Weiss ; M.D. ; Christopher L. Wolfgang ; M.D. ; Ph.D. ; ^{cwolfga2@jhmi.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pancreatectomy ; Readmission ; Mortality ; Outcomes
• 刊名：The American Journal of Surgery
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：210
• 期：4
• 页码：636-642.e1
• 全文大小：357 K

文摘

The purpose of this study was to investigate the prognostic significance of early (30-day) hospital readmission (EHR) on mortality after pancreatectomy.

bsSec_2">Methods

bspara0015">Using a prospectively collected institutional database linked with a statewide dataset, we evaluated the association between EHR and overall mortality in all patients undergoing pancreatectomy at our tertiary institution (2005 to 2010).

bsSec_3">Results

bspara0020">Of 595 pancreatectomy patients, EHR occurred in 21.5%. Overall mortality was 29.4% (median follow-up 22.7 months). Patients with EHR had decreased survival compared with those who were not readmitted (P = .011). On multivariate analysis adjusting for baseline group differences, EHR for gastrointestinal-related complications was a significant independent predictor of mortality (hazard ratio 2.30, P = .001).

bsSec_4">Conclusions

bspara0025">In addition to known risk factors, 30-day readmission for gastrointestinal-related complications following pancreatectomy independently predicts increased mortality. Additional studies are necessary to identify surgical, medical, and social factors contributing to EHR, as well as interventions aimed at decreasing postpancreatectomy morbidity and mortality.