title: Factors associated with recidivism following pancreaticoduodenectomy.
abstract: OBJECTIVE
  Factors related to readmission after pancreaticoduodenectomy (PD) may include postoperative morbidity and the functional status of the patient. This study aimed to retrospectively review our institution's experience of readmission of patients who had undergone Whipple procedure PD.
  
  
  METHODS
  Recidivism was defined as readmission to the primary or a secondary hospital within, respectively, 30 days, 30-90 days or 90 days postoperatively. Associations between recidivism, perioperative factors and patient characteristics were evaluated.
  
  
  RESULTS
  During the past 5 years, 30-day, 30-90-day and 90-day recidivism rates were 14.5%, 18.5% and 27.4%, respectively. The most common reasons for readmission included dehydration and/or malnutrition (37.5% of readmissions) and pain (12.5%). Patients who underwent PD for chronic pancreatitis were more likely to be readmitted within 90 days of surgery than patients who underwent PD for malignancy (P < 0.01). Intraoperative transfusion was also associated with 30-90-day and 90-day recidivism (P < 0.01). Preoperative comorbidities, including Charlson Comorbidity Index score, number of pre-discharge complications, type of Whipple reconstruction, preoperative biliary stenting, need for vascular reconstruction and patient body mass index were not associated with recidivism.
  
  
  CONCLUSIONS
  Our data confirm previous reports indicating high rates of readmission after PD. To our knowledge, this report is the first to demonstrate chronic pancreatitis as an independent risk factor for readmission.
authors.affiliation: Department of Surgery, University of Cincinnati Medical Center, OH, USA.
authors.forename: Sanjeet S
authors.initials: SS
authors.lastname: Grewal
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: McClaine
authors.forename: Nathan
authors.initials: N
authors.lastname: Schmulewitz
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Alzahrani
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Hanseman
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Sussman
authors.forename: Milton
authors.initials: M
authors.lastname: Smith
authors.forename: Kyuran A
authors.initials: KA
authors.lastname: Choe
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Olowokure
authors.forename: Michelle
authors.initials: M
authors.lastname: Mierzwa
authors.forename: Syed A
authors.initials: SA
authors.lastname: Ahmad
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D050500:Pancreatitis, Chronic / Q000150:complications / Q000601:surgery*; D010359:Patient Readmission; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
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