Predictors of 30-day readmission following pancreatic surgery: A retrospective review
Leo I. Amodu a,b, Jamil Alexis a,b, Aron Soleiman b, Meredith Akerman c, Poppy Addison a,b, Toni Iurcotta a,b, Horacio L. Rodriguez Rilo a,b,∗
a Department of Surgery, Hofstra-Northwell School of Medicine, Hempstead, NY, USA
b Pancreas Disease Center, Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA
c Department of Biostatistics, Feinstein Institute for Medical Research, Manhasset, NY, USA ∗ Corresponding author at: Pancreas Disease Center, Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA.
E-mail address: Hrilo@northwell.edu (H.L.R. Rilo).
BACKGROUND: Pancreatectomies have been identified as procedures with an increased risk of readmission. In surgical patients, readmissions within 30 days of discharge are usually procedure-related. We sought to determine predictors of 30-day readmission following pancreatic resections in a large healthcare system.
METHODS: We retrospectively collected information from the records of 383 patients who underwent pancreatic resections from 2004-2013. To find the predictors of readmission in the 30 days after discharge, we performed a univariate screen of possible variables using the Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables. Multivariate analysis was used to determine the independent factors.
RESULTS: Fifty-eight (15.1%) patients were readmitted within 30 days of discharge. Of the patients readmitted, the most common diagnoses at readmission were sepsis (17.2%), and dehydration (8.6%). Multivariate logistic regression found that the development of intra-abdominal fluid collections (OR?=?5.32, P?<?0.0001), new thromboembolic events (OR?=?4.08, P?=?0.016), and pre-operative BMI (OR?=?1.06, P?=?0.040) were independent risk factors of readmission within 30 days of discharge.
CONCLUSION: Our data demonstrate that factors predictive of 30-day readmission are a combination of patient characteristics and the development of post-operative complications. Targeted interventions may be used to reduce the risk of readmission.
2018, Vol. 17 
