|Hospital readmission after a pancreaticoduodenectomy: an emerging quality metric?|
|PMID: 23297725 Owner: NLM Status: MEDLINE|
|BACKGROUND: Hospital readmission has attracted attention from policymakers as a measure of quality and a target for cost reduction. The aim of the study was to evaluate the frequency and patterns of rehospitalization after a pancreaticoduodenectomy (PD).
METHODS: The records of all patients undergoing a PD at an academic medical centre for malignant or benign diagnoses between January 2006 and September 2011 were retrospectively reviewed. The incidence, aetiology and predictors of subsequent readmission(s) were analysed.
RESULTS: Of 257 consecutive patients who underwent a PD, 50 (19.7%) were readmitted within 30 days from discharge. Both the presence of any post-operative complication (P = 0.049) and discharge to a nursing/rehabilitation facility or to home with health care services (P = 0.018) were associated with readmission. The most common reasons for readmission were diet intolerance (36.0%), pancreatic fistula/abscess (26.0%) and superficial wound infection (8.0%). Nine (18.0%) readmissions had lengths of stay of 2 days or less and in four of those (8.0%) diagnostic evaluation was eventually negative.
CONCLUSION: Approximately one-fifth of patients require hospital readmission within 30 days of discharge after a PD. A small fraction of these readmissions are short (2 days or less) and may be preventable or manageable in the outpatient setting.
|Zachary J Kastenberg; John M Morton; Brendan C Visser; Jeffrey A Norton; George A Poultsides|
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|Type: Journal Article Date: 2012-09-24|
|Title: HPB : the official journal of the International Hepato Pancreato Biliary Association Volume: 15 ISSN: 1477-2574 ISO Abbreviation: HPB (Oxford) Publication Date: 2013 Feb|
|Created Date: 2013-01-09 Completed Date: 2013-08-02 Revised Date: 2014-02-04|
Medline Journal Info:
|Nlm Unique ID: 100900921 Medline TA: HPB (Oxford) Country: England|
|Languages: eng Pagination: 142-8 Citation Subset: IM|
|© 2012 International Hepato-Pancreato-Biliary Association.|
|APA/MLA Format Download EndNote Download BibTex|
California / epidemiology
Length of Stay / economics, statistics & numerical data*
Pancreatic Diseases / surgery
Pancreatic Fistula / epidemiology, etiology, surgery
Pancreaticoduodenectomy* / adverse effects, statistics & numerical data
Patient Discharge / economics, statistics & numerical data*
Patient Readmission / economics, statistics & numerical data*
Surgical Wound Infection / epidemiology, etiology
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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