Factors Associated with 60-Day Readmission Following Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy

Introduction Readmission rates following surgery are subject to scrutiny in efforts to control health care costs. This study was designed to define the 60-day readmission rate following cytoreduction and HIPEC at a high-volume center and to identify factors associated with readmission. Methods Patie...

Celý popis

Uložené v:
Podrobná bibliografia
Vydané v:Annals of surgical oncology Ročník 25; číslo 1; s. 91 - 97
Hlavní autori: Kelly, Kaitlyn J., Cajas, Luis, Baumgartner, Joel M., Lowy, Andrew M.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Cham Springer International Publishing 01.01.2018
Springer Nature B.V
Predmet:
Adult
Aged
Antineoplastic Agents - administration & dosage
Carcinoma - secondary
Carcinoma - therapy
Chemotherapy
Comorbidity
Cytoreduction Surgical Procedures - adverse effects
Dehydration
Dehydration - etiology
Female
Gastrointestinal Oncology
Humans
Hyperthermia, Induced - adverse effects
Ileus - etiology
Infection - etiology
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Oncology
Ostomy - adverse effects
Patient admissions
Patient Readmission - statistics & numerical data
Peritoneal Neoplasms - secondary
Peritoneal Neoplasms - therapy
Postoperative Complications - etiology
Pulmonary Embolism - etiology
Retrospective Studies
Risk Factors
Risk groups
Surgery
Surgical Oncology
Venous Thrombosis - etiology
Young Adult
Cytoreductive Surgery And Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC)
Control Health Care Costs
Deep Space Infection
Stoma Creation
Peritoneal Carcinomatosis Index (PCI)
ISSN:1068-9265, 1534-4681, 1534-4681
On-line prístup:Získať plný text
Tagy: Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
Popis
Shrnutí:Introduction Readmission rates following surgery are subject to scrutiny in efforts to control health care costs. This study was designed to define the 60-day readmission rate following cytoreduction and HIPEC at a high-volume center and to identify factors associated with readmission. Methods Patients who underwent complete cytoreduction and HIPEC at a single institution from August 2007 through June 2014 were identified from a prospectively maintained database. Multiple preoperative and operative factors were analyzed for their ability to predict 60-day readmission following surgery. Results A total of 250 patients were identified. Forty patients (17%) experienced readmission within 60 days of surgery. The most common reasons for readmission were ileus/dehydration (12, 31%), deep space infection (8, 21%), and DVT/PE (6, 15%). Initial postoperative length of stay was longer for patients readmitted within 60 days (median 12 vs. 9 days, p  = 0.013). Of categorical variables analyzed, including gender, histology, HIPEC agent, intraoperative transfusion, and individual procedures performed during cytoreduction, adjuvant systemic therapy, and postoperative morbidity, only Charlson comorbidity index CCI (odds ratio (OR) = 3.80 [1.68–8.60]) and stoma creation (OR = 6.04 [1.56–12.14]) were associated with 60-day readmission. Conclusions Few measurable variables are associated with readmission following cytoreduction and HIPEC. Patients with high CCI and those with stomas created at the time of CRS/HIPEC may be at increased risk of readmission within 60 days. Earlier or more frequent follow-up for high-risk patients should be considered as a strategy to reduce readmissions.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:1068-9265
1534-4681
1534-4681
DOI:10.1245/s10434-017-6108-8