title: Hospital readmission after pancreaticoduodenectomy.
abstract: Data exist on the morbidity and mortality of patients undergoing pancreaticoduodenectomy (PD), but there are few reports about hospital readmissions after this procedure. Our aim was to evaluate the number of and reasons for readmission after PD and the factors influencing readmission. We reviewed the initial hospitalization and readmissions for 1643 patients undergoing PD compared patients requiring readmission to patients that did not require readmission. Twenty-six percent of patients were readmitted a total of 678 times after PD. Patients readmitted were younger than those not readmitted (61.8 versus 64.6 years, P < 0.0001). Vessel resection, abscess formation, wound infection, postoperative percutaneous biliary stents, estimated blood loss >1000 ml, and age < or =65 years were independently associated with readmission. The length of stay for all patients decreased over time, from 10.5 days in 1996 to 7 days in 2003. The percentage of patients being readmitted also decreased from 33% in 1996 to 20% (P = 0.004) in 2003. The readmission rate after PD was 26%. Younger age, blood loss, postoperative complications, and vessel resection were independent risk factors for readmission. The early hospital readmission rate has not increased in association with a decreased LOS, supporting the idea that reduction in LOS did not lead to increased readmission rates.
authors.affiliation: Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Emick
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Riall
authors.forename: John L
authors.initials: JL
authors.lastname: Cameron
authors.forename: Jordan M
authors.initials: JM
authors.lastname: Winter
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
authors.forename: Joann
authors.initials: J
authors.lastname: Coleman
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Sauter
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Yeo
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012189:Retrospective Studies