Hospital readmission after a pancreaticoduodenectomy: an emerging quality metric?. Issue 2 (24th September 2012)

• Record Type: Journal Article
• Authors: Kastenberg, Zachary J.; Morton, John M.; Visser, Brendan C.; Norton, Jeffrey A.; Poultsides, George A.
• Is Part Of: HPB. Volume 15:Issue 2(2013:Feb.)
• Page Start: 142
• Page End: 148
• Publication Date: 2012-09-24
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/j.1477-2574.2012.00563.x
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb563-sec-0001" sec-type="section"> <title>Background</title> <p>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).</p> </sec> <sec id="hpb563-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="hpb563-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 0.049) and discharge to a nursing/rehabilitation facility or to home with health care services (<italic>P</italic> = 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.</p> </sec> <sec id="hpb563-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>