Document Detail


Hospital readmission after a pancreaticoduodenectomy: an emerging quality metric?
MedLine Citation:
PMID:  23297725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Zachary J Kastenberg; John M Morton; Brendan C Visser; Jeffrey A Norton; George A Poultsides
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Publication Detail:
Type:  Journal Article     Date:  2012-09-24
Journal Detail:
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 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  142-8     Citation Subset:  IM    
Copyright Information:
© 2012 International Hepato-Pancreato-Biliary Association.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Abscess / epidemiology,  etiology,  surgery
Aged
California / epidemiology
Cohort Studies
Female
Follow-Up Studies
Hospital Mortality
Hospitals, University
Humans
Incidence
Length of Stay / economics,  statistics & numerical data*
Male
Middle Aged
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*
Retrospective Studies
Risk Factors
Surgical Wound Infection / epidemiology,  etiology
Survival Rate
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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