title: Readmission After Liver Resection for Intrahepatic Cholangiocarcinoma: a Multi-Institutional Analysis.
abstract: BACKGROUND
  The objective of the current study was to define the incidence of 30-day readmission after hepatic resection for intrahepatic cholangiocarcinoma (ICC). In particular, we sought to identify risk factors associated with a higher risk of readmission among patients undergoing resection for ICC.
  
  
  METHODS
  Patients who underwent hepatic resection for ICC at 12 major hepatobiliary centers in the USA, Europe, Australia, and Asia between 1990 and 2013 were identified. Thirty-day readmission and clinicopathologic characteristics associated with higher risk of readmission were examined.
  
  
  RESULTS
  Among 602 patients, 401 (68.3%) patients underwent a major hepatectomy and 256 (43.3%) experienced at least one post-operative complication. Overall 30-day readmission was 7.8% (n = 47). Risk factors associated with readmission included pre-operative jaundice (odds ratio (OR) 2.45) and the presence of a major complication (OR 3.38). In fact, 95.7% of readmitted patients had experienced a post-operative complication versus only 38.8% of non-readmitted patients (P < 0.001). Among patients who were readmitted, repeat hospitalization was associated with a median LOS of 6.5 days (interquartile range (IQR) 4.0-11.5) and one patient died during readmission.
  
  
  CONCLUSIONS
  Readmission after hepatic resection for ICC occurred in 1 in 13 patients. Patients with pre-operative jaundice and those who experienced a complication had over a threefold higher risk of being readmitted.
authors.affiliation: The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Gaya
authors.initials: G
authors.lastname: Spolverato
authors.forename: Hadia
authors.initials: H
authors.lastname: Maqsood
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vitale
authors.forename: Sorin
authors.initials: S
authors.lastname: Alexandrescu
authors.forename: Hugo P
authors.initials: HP
authors.lastname: Marques
authors.forename: Luca
authors.initials: L
authors.lastname: Aldrighetti
authors.forename: T Clark
authors.initials: TC
authors.lastname: Gamblin
authors.forename: Carlo
authors.initials: C
authors.lastname: Pulitano
authors.forename: Todd W
authors.initials: TW
authors.lastname: Bauer
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
authors.forename: George
authors.initials: G
authors.lastname: Poultsides
authors.forename: Shishir
authors.initials: S
authors.lastname: Maithel
authors.forename: J Wallis
authors.initials: JW
authors.lastname: Marsh
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007565:Jaundice / Q000150:complications; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors