The timing of complications impacts risk of readmission after hepatopancreatobiliary surgery

Donald J. Lucas, John F. Sweeney, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

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

Original languageEnglish (US)
Pages (from-to)945-953
Number of pages9
JournalSurgery
Volume155
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Operative Surgical Procedures
Hepatectomy
Medicare
Quality Improvement
Odds Ratio
Confidence Intervals
Pathology
Incidence
Anesthesiologists
Datasets

ASJC Scopus subject areas

  • Surgery

Cite this

The timing of complications impacts risk of readmission after hepatopancreatobiliary surgery. / Lucas, Donald J.; Sweeney, John F.; Pawlik, Timothy M.

In: Surgery, Vol. 155, No. 5, 2014, p. 945-953.

Research output: Contribution to journalArticle

Lucas, Donald J. ; Sweeney, John F. ; Pawlik, Timothy M. / The timing of complications impacts risk of readmission after hepatopancreatobiliary surgery. In: Surgery. 2014 ; Vol. 155, No. 5. pp. 945-953.
@article{be8a0c19c0a440b08575280552709ec5,
title = "The timing of complications impacts risk of readmission after hepatopancreatobiliary surgery",
abstract = "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",
author = "Lucas, {Donald J.} and Sweeney, {John F.} and Pawlik, {Timothy M.}",
year = "2014",
doi = "10.1016/j.surg.2013.12.034",
language = "English (US)",
volume = "155",
pages = "945--953",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "5",

}

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

UR - http://www.scopus.com/inward/record.url?scp=84899952794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899952794&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2013.12.034

DO - 10.1016/j.surg.2013.12.034

M3 - Article

C2 - 24661768

AN - SCOPUS:84899952794

VL - 155

SP - 945

EP - 953

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 5

ER -