title: Early hospital readmission for gastrointestinal-related complications predicts long-term mortality after pancreatectomy.
abstract: BACKGROUND
  The purpose of this study was to investigate the prognostic significance of early (30-day) hospital readmission (EHR) on mortality after pancreatectomy.
  
  
  METHODS
  Using a prospectively collected institutional database linked with a statewide dataset, we evaluated the association between EHR and overall mortality in all patients undergoing pancreatectomy at our tertiary institution (2005 to 2010).
  
  
  RESULTS
  Of 595 pancreatectomy patients, EHR occurred in 21.5%. Overall mortality was 29.4% (median follow-up 22.7 months). Patients with EHR had decreased survival compared with those who were not readmitted (P = .011). On multivariate analysis adjusting for baseline group differences, EHR for gastrointestinal-related complications was a significant independent predictor of mortality (hazard ratio 2.30, P = .001).
  
  
  CONCLUSIONS
  In addition to known risk factors, 30-day readmission for gastrointestinal-related complications following pancreatectomy independently predicts increased mortality. Additional studies are necessary to identify surgical, medical, and social factors contributing to EHR, as well as interventions aimed at decreasing postpancreatectomy morbidity and mortality.
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Caitlin W
authors.initials: CW
authors.lastname: Hicks
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tosoian
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Craig-Schapiro
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Cameron
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Frederic E
authors.initials: FE
authors.lastname: Eckhauser
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hirose
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Nita
authors.initials: N
authors.lastname: Ahuja
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Weiss
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. Electronic address: cwolfga2@jhmi.edu.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wolfgang
mesh_terms: D000368:Aged; D016208:Databases, Factual; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000401:mortality*; D010182:Pancreatic Diseases / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
keywords: Mortality; Outcomes; Pancreatectomy; Readmission