Hospital readmission after distal pancreatectomy is predicted by specific intra- and post-operative factors

Am J Surg. 2018 Sep;216(3):511-517. doi: 10.1016/j.amjsurg.2017.12.007. Epub 2017 Dec 14.

Abstract

Background: Distal pancreatectomy (DP) continues to carry a significant risk of morbidity resulting in hospital readmissions and increased costs. Prognostic factors predicting 30-day readmission after DP were evaluated.

Methods: Data were collected from 946 patients undergoing DP at the University of Verona Hospital Trust and the Massachusetts General Hospital between 2004 and 2014. Patients were divided into a derivation and a validation cohort.

Results: The 30-day readmission rate was 13.9%. Predictors of readmission were age over 60 years (OR 1.8), intraoperative transfusions (OR 2.02), CR-POPF (OR 2.4), abdominal abscesses (OR 3.9), and urinary tract infections (OR 5.9). The score generated by the derivation cohort was validated identifying three different categories with a progressively increased risk for readmission.

Conclusion: One out of seven patients undergoing DP will be readmitted within 30 days of discharge. Comorbidities seems not to affect the risk. A 10-point score predicts the risk of 30-days readmission.

Keywords: Distal pancreatectomy; Outcome; Pancreatic fistula; Readmission; Score.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Period
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Morbidity / trends
  • Pancreatectomy / methods*
  • Patient Readmission / trends*
  • Postoperative Complications / epidemiology*
  • Postoperative Period
  • Prognosis
  • Retrospective Studies
  • United States / epidemiology
  • Young Adult