TY - JOUR
T1 - The timing of complications impacts risk of readmission after hepatopancreatobiliary surgery
AU - Lucas, Donald J.
AU - Sweeney, John F.
AU - Pawlik, Timothy M.
PY - 2014
Y1 - 2014
N2 - Background Readmission is frequent in hepatopancreatobiliary (HPB) surgery. Medicare began penalizing hospitals recently for excess readmission for specific diagnoses, including some operative procedures. We sought to define the incidence and risk factors for readmission after HPB surgery. Study design Elective HPB resections were selected from the 2011 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) dataset. Risk factors associated with readmission were assessed using modified Poisson univariate and adjusted regression models. Results We identified 5,081 patients; 2,980 underwent pancreatic resection and 2,101 had a hepatectomy. Median age was 62 (interquartile range, 52-70), 53% of patients were women; 74% were non-Hispanic white; and 31% were American Society of Anesthesiologists (ASA) class 2, and 64% were ASA class 3. About 75% of cases had a malignant diagnosis on final pathology. Of all these patients, 16.2% were readmitted within 30 days of operation. The strongest risk factors for readmission on multivariable analysis were minor (risk ratio [RR], 3.13, 95% confidence interval [CI], 2.47-3.97; P
AB - Background Readmission is frequent in hepatopancreatobiliary (HPB) surgery. Medicare began penalizing hospitals recently for excess readmission for specific diagnoses, including some operative procedures. We sought to define the incidence and risk factors for readmission after HPB surgery. Study design Elective HPB resections were selected from the 2011 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) dataset. Risk factors associated with readmission were assessed using modified Poisson univariate and adjusted regression models. Results We identified 5,081 patients; 2,980 underwent pancreatic resection and 2,101 had a hepatectomy. Median age was 62 (interquartile range, 52-70), 53% of patients were women; 74% were non-Hispanic white; and 31% were American Society of Anesthesiologists (ASA) class 2, and 64% were ASA class 3. About 75% of cases had a malignant diagnosis on final pathology. Of all these patients, 16.2% were readmitted within 30 days of operation. The strongest risk factors for readmission on multivariable analysis were minor (risk ratio [RR], 3.13, 95% confidence interval [CI], 2.47-3.97; P
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U2 - 10.1016/j.surg.2013.12.034
DO - 10.1016/j.surg.2013.12.034
M3 - Article
C2 - 24661768
AN - SCOPUS:84899952794
SN - 0039-6060
VL - 155
SP - 945
EP - 953
JO - Surgery
JF - Surgery
IS - 5
ER -