Shaila J Merchant1, Philip H G Ituarte1, Audrey Choi1, Virginia Sun2, Joseph Chao3, Byrne Lee1, Joseph Kim4. 1. Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA. 2. Nursing Research and Education, City of Hope National Medical Center, Duarte, CA, USA. 3. Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA. 4. Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA. joekim7@yahoo.com.
Abstract
BACKGROUND: Readmission rates after cancer surgery are infrequently reported, and better understanding of the etiologies for readmission is necessary. We sought to investigate the frequency, timing, and etiologies for hospital readmission after surgery for gastric cancer and whether readmission correlates with clinical outcomes. STUDY DESIGN: Hospital readmission was examined through linkage of the California Cancer Registry with the Office of Statewide Health Planning and Development database. Patients with gastric adenocarcinoma who had undergone curative intent surgery between 2000 and 2011 were identified. First readmission within 90 days of initial surgery was analyzed with respect to timing (0-30, 31-60, and 61-90 days) and etiology for readmission. Variables associated with readmission and impact on 5-year overall survival (OS) were examined. RESULTS: A total of 8887 (male, n = 5326; female, n = 3561) patients underwent curative intent surgery for gastric adenocarcinoma. Within 90 days of initial surgery, 2559 (28.8 %) patients had inpatient hospital readmission. The majority of readmissions occurred in the first 30 days [0-30, n = 1371 (53.6 %); 31-60, n = 773 (30.2 %); and 61-90, n = 415 (16.2 %)]. Readmission vs. no readmission within 90 days correlated with worse 5-year OS in patients with local (51.2 vs. 70.9 %, p < 0.0001) and regional (23.3 vs. 32.9 %, p < 0.0001) disease. On multivariate analysis, readmission within 90 days was associated with worse OS (HR 1.40, 95 % CI 1.32-1.49, p < 0.001). CONCLUSIONS: Hospital readmissions are high after surgery for gastric cancer and correlate with poor patient survival. A better understanding of these issues may allow health care providers to potentially lower readmission rates and improve gastric cancer outcomes.
BACKGROUND: Readmission rates after cancer surgery are infrequently reported, and better understanding of the etiologies for readmission is necessary. We sought to investigate the frequency, timing, and etiologies for hospital readmission after surgery for gastric cancer and whether readmission correlates with clinical outcomes. STUDY DESIGN: Hospital readmission was examined through linkage of the California Cancer Registry with the Office of Statewide Health Planning and Development database. Patients with gastric adenocarcinoma who had undergone curative intent surgery between 2000 and 2011 were identified. First readmission within 90 days of initial surgery was analyzed with respect to timing (0-30, 31-60, and 61-90 days) and etiology for readmission. Variables associated with readmission and impact on 5-year overall survival (OS) were examined. RESULTS: A total of 8887 (male, n = 5326; female, n = 3561) patients underwent curative intent surgery for gastric adenocarcinoma. Within 90 days of initial surgery, 2559 (28.8 %) patients had inpatient hospital readmission. The majority of readmissions occurred in the first 30 days [0-30, n = 1371 (53.6 %); 31-60, n = 773 (30.2 %); and 61-90, n = 415 (16.2 %)]. Readmission vs. no readmission within 90 days correlated with worse 5-year OS in patients with local (51.2 vs. 70.9 %, p < 0.0001) and regional (23.3 vs. 32.9 %, p < 0.0001) disease. On multivariate analysis, readmission within 90 days was associated with worse OS (HR 1.40, 95 % CI 1.32-1.49, p < 0.001). CONCLUSIONS: Hospital readmissions are high after surgery for gastric cancer and correlate with poor patient survival. A better understanding of these issues may allow health care providers to potentially lower readmission rates and improve gastric cancer outcomes.
Authors: Oliver Anderson; Zhifang Ni; Henrik Møller; Victoria H Coupland; Elizabeth A Davies; William H Allum; George B Hanna Journal: Eur J Cancer Date: 2011-08-09 Impact factor: 9.162
Authors: Robert C G Martin; Russell Brown; Lisa Puffer; Stacey Block; Glenda Callender; Amy Quillo; Charles R Scoggins; Kelly M McMasters Journal: Ann Surg Date: 2011-10 Impact factor: 12.969
Authors: Greg D Sacks; Aaron J Dawes; Marcia M Russell; Anne Y Lin; Melinda Maggard-Gibbons; Deborah Winograd; Hallie R Chung; James Tomlinson; Areti Tillou; Stephen B Shew; Darryl T Hiyama; H Gill Cryer; F Charles Brunicardi; Jonathan R Hiatt; Clifford Ko Journal: JAMA Surg Date: 2014-08 Impact factor: 14.766
Authors: Aaron J Dawes; Greg D Sacks; Marcia M Russell; Anne Y Lin; Melinda Maggard-Gibbons; Deborah Winograd; Hallie R Chung; Areti Tillou; Jonathan R Hiatt; Clifford Ko Journal: J Am Coll Surg Date: 2014-04-13 Impact factor: 6.113
Authors: Victoria H Coupland; Jesper Lagergren; Margreet Lüchtenborg; Ruth H Jack; William Allum; Lars Holmberg; George B Hanna; Neil Pearce; Henrik Møller Journal: Gut Date: 2012-10-19 Impact factor: 23.059
Authors: Irina Yermilov; David Bentrem; Evan Sekeris; Sushma Jain; Melinda A Maggard; Clifford Y Ko; James S Tomlinson Journal: Ann Surg Oncol Date: 2008-11-11 Impact factor: 5.344
Authors: Sophia Y Chen; Miloslawa Stem; Susan L Gearhart; Bashar Safar; Sandy H Fang; Nilofer S Azad; Adrian G Murphy; Amol K Narang; Christopher L Wolfgang; Jonathan E Efron Journal: World J Surg Date: 2019-10 Impact factor: 3.352
Authors: Alexandra W Acher; Malcolm H Squires; Ryan C Fields; George A Poultsides; Carl Schmidt; Konstantinos I Votanopoulos; Timothy M Pawlik; Linda X Jin; Aslam Ejaz; David A Kooby; Mark Bloomston; David Worhunsky; Edward A Levine; Neil Saunders; Emily Winslow; Clifford S Cho; Glen Leverson; Shishir K Maithel; Sharon M Weber Journal: J Gastrointest Surg Date: 2016-04-21 Impact factor: 3.452
Authors: Allison N Martin; Deepanjana Das; Florence E Turrentine; Todd W Bauer; Reid B Adams; Victor M Zaydfudim Journal: J Gastrointest Surg Date: 2016-06-30 Impact factor: 3.452