Lactate Dehydrogenase and Risk of Readmission with Gastric Cancer: A Propensity Score Matching Analysis

J Invest Surg. 2023 Dec 31;36(1):2172488. doi: 10.1080/08941939.2023.2172488. Epub 2023 Feb 12.

Abstract

Purpose: Readmission is one of the measures of quality of care and potential costs. This study aimed to determine whether lactate dehydrogenase (LDH) is associated with an increased risk of 30-day readmission in gastric cancer.

Methods: We performed a retrospective study of patients who underwent radical gastrectomy for gastric cancer at our institution between July 2014 and May 2018. Balanced cohorts were created by propensity score matching (PSM) with a 1:1 ratio to generate the elevated LDH (ELDH) group (n = 151) and the low LDH group (Control) (n = 302). To determine the incidence, causes, and risk factors of 30-day readmission, subgroup analyzes were performed and used to develop an efficient prediction model.

Results: A total of 788 patients met the criteria to be included in the study. The cutoff value for serum LDH was 215.5. After PSM, a total of 302 patients were matched in pairs (ELDH group, n = 151, Control group, n = 151). ELDH levels had a higher risk of readmission (p = 0.005, Odds ratio 3.768, 95% confidence interval 1.493-9.510). The pre-match 30-day readmission rate was 7.2 percent, and common causes of post-match readmission included infection-related symptoms, gastrointestinal symptoms, and gastrointestinal bleeding.

Conclusions: Patients with preoperative ELDH levels, postoperative complications, and high preoperative American Society of Anesthesiologists Scores had a higher risk of readmission 30 days after surgery.

Keywords: Serum lactate dehydrogenase; gastric cancer; postoperative complications; propensity score matching; readmission.

MeSH terms

  • Gastrectomy / adverse effects
  • Humans
  • Lactate Dehydrogenases
  • Patient Readmission
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Propensity Score
  • Retrospective Studies
  • Stomach Neoplasms* / epidemiology
  • Stomach Neoplasms* / surgery

Substances

  • Lactate Dehydrogenases