G W de Klein1, R M Brohet2, M S L Liem3, J M Klaase4. 1. Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands. g.deklein@mst.nl. 2. Department of Research and Innovation, Isala, Zwolle, The Netherlands. 3. Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands. 4. Department of Hepatobiliary Surgery and Liver Transplantation, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
INTRODUCTION: Unplanned readmission is a common event after liver resection, and it is a burden for both patients and healthcare policy makers. This study evaluates the incidence of and reasons for unplanned readmission after liver resection, in order to identify possible preventable causes. METHODS: In this single-center cohort study, data from patients who underwent liver resection for both malignant and benign indications from 2001 to 2016 at our institute were collected from a database with prospective data. Readmissions were analyzed for their reasons and risk factors. Patients with general complaints with no specific complications were categorized as failure to thrive. RESULTS: In 406 patients, the readmission rate was 11.6%. Most patients were readmitted because of failure to thrive (35%), deep and superficial surgical site infection (28%), or cardiopulmonary complications (15%). A multivariate analysis revealed that unplanned readmission was associated with the occurrence of complications during index admission-with an odds ratio of 4.69 (CI 2.41-9.12, p < 0.001). CONCLUSION: Readmission occurs in more than 1 in 10 patients after liver resection, and it is associated with a complicated course during index admission. One-third of readmissions occur because of failure to thrive and might be preventable. Future research in strategies to reduce readmission rates should focus on both the prevention of complications during index admission and programs at the interface between primary and secondary care.
INTRODUCTION: Unplanned readmission is a common event after liver resection, and it is a burden for both patients and healthcare policy makers. This study evaluates the incidence of and reasons for unplanned readmission after liver resection, in order to identify possible preventable causes. METHODS: In this single-center cohort study, data from patients who underwent liver resection for both malignant and benign indications from 2001 to 2016 at our institute were collected from a database with prospective data. Readmissions were analyzed for their reasons and risk factors. Patients with general complaints with no specific complications were categorized as failure to thrive. RESULTS: In 406 patients, the readmission rate was 11.6%. Most patients were readmitted because of failure to thrive (35%), deep and superficial surgical site infection (28%), or cardiopulmonary complications (15%). A multivariate analysis revealed that unplanned readmission was associated with the occurrence of complications during index admission-with an odds ratio of 4.69 (CI 2.41-9.12, p < 0.001). CONCLUSION: Readmission occurs in more than 1 in 10 patients after liver resection, and it is associated with a complicated course during index admission. One-third of readmissions occur because of failure to thrive and might be preventable. Future research in strategies to reduce readmission rates should focus on both the prevention of complications during index admission and programs at the interface between primary and secondary care.
Authors: Lidewij Spelt; Daniel Ansari; Christian Sturesson; Bobby Tingstedt; Roland Andersson Journal: HPB (Oxford) Date: 2011-09-26 Impact factor: 3.647
Authors: R M van Dam; P O Hendry; M M E Coolsen; M H A Bemelmans; K Lassen; A Revhaug; K C H Fearon; O J Garden; C H C Dejong Journal: Br J Surg Date: 2008-08 Impact factor: 6.939
Authors: Gaya Spolverato; Hadia Maqsood; Alessandro Vitale; Sorin Alexandrescu; Hugo P Marques; Luca Aldrighetti; T Clark Gamblin; Carlo Pulitano; Todd W Bauer; Feng Shen; George Poultsides; Shishir Maithel; J Wallis Marsh; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2015-04-23 Impact factor: 3.452
Authors: Nicolai A Schultz; Peter N Larsen; B Klarskov; L M Plum; Hans-Jørgen Frederiksen; Henrik Kehlet; Jens G Hillingsø Journal: World J Surg Date: 2018-06 Impact factor: 3.352
Authors: Dietmar Tamandl; Jean M Butte; Peter J Allen; Michael I D'Angelica; Ronald P DeMatteo; Jeffrey S Groeger; William R Jarnagin; Yuman Fong Journal: Surgery Date: 2015-02 Impact factor: 3.982
Authors: Charles W Kimbrough; Steven C Agle; Charles R Scoggins; Robert C G Martin; Michael R Marvin; Eric G Davis; Kelly M McMasters; Christopher M Jones Journal: Surgery Date: 2014-07-30 Impact factor: 3.982
Authors: Florence E Turrentine; Timothy L McMurry; Mark E Smolkin; R Scott Jones; Victor M Zaydfudim Journal: J Gastrointest Surg Date: 2021-05-04 Impact factor: 3.452