Discharge disposition after pancreatic resection for malignancy: analysis of national trends.
OBJECTIVE
The aim of this study is to analyse national trends in discharge disposition following pancreatic resection for malignancy in the USA.


METHODS
The Nationwide Inpatient Sample database was queried for 1993-2005 to identify patients who underwent pancreatic resection for malignancy. The status of patients at discharge (to home, home with home health care or to another facility) was noted.


RESULTS
A weighted total of 51 866 patients who underwent pancreatectomy for malignant neoplasm of the pancreas were identified. Patients who died in the postoperative period and patients without a specified discharge disposition were excluded, leaving 43 603 patients for inclusion in the study. Overall mortality improved over the period of the study from 7.1% in 1993 to 5.2% in 2005. The number of patients discharged to another facility increased significantly from 5.5% in 1993 to 13.3% in 2005. Similarly, the number of patients discharged to home with home health assistance increased from 20.0% in 1993 to 33.0% in 2005. This corresponded with a statistically significant decrease in the number of patients discharged to home without assistance, from 74.5% in 1993 to 53.7% in 2005 (P= 0.002).


CONCLUSIONS
The results of our study demonstrate that following pancreatic resection for malignancy, nearly half the patients will require some assistance after discharge.
Division of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Bhavin C
BC
Shah
Lynette M
LM
Smith
Fred
F
Ullrich
Chandrakanth
C
Are
D000368:Aged; D016009:Chi-Square Distribution; D019992:Databases as Topic; D005260:Female; D006268:Health Facilities / Q000639:trends*; D006699:Home Care Services / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D010351:Patient Discharge / Q000639:trends*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology