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. 2011 Feb;13(2):96-102.
doi: 10.1111/j.1477-2574.2010.00251.x.

National trends in discharge disposition after hepatic resection for malignancy

Bhavin C Shah  1 , Fred Ullrich, Lynette Smith, Premila Leiphrakpam, Quan Ly, Aaron Sasson, Chandrakanth Are
Affiliations

National trends in discharge disposition after hepatic resection for malignancy

Bhavin C Shah et al. HPB (Oxford). 2011 Feb.

Abstract

Background: There is a paucity of data on the trends in discharge disposition for patients undergoing hepatic resection for malignancy.

Aim: To analyse the national trends in discharge disposition after hepatic resection for malignancy.

Methods: The National Inpatient Sample (NIS) database was queried (1993 to 2005) to identify patients that underwent hepatic resection for malignancy and analyse the discharge status (home, home health or rehabilitation/skilled facility).

Results: A weighted total of 74,520 patients underwent hepatic resection of whom, 53,770 patients had a principal diagnosis of malignancy. The overall mortality improved from 6.3% to 3.4%. After excluding patients that died in the post-operative period and those with incomplete discharge status, 45,583 patients were included. The proportion of patients that had acute care needs preventing them from being discharged home without assistance increased from 10.9% in 1993 to 19.5% in 2005. While there was an increase in the number of patients discharged to home health care during this time (8.9% to 13.8%), there was a larger increase in the proportion of patients that were discharged to a rehabilitation or skilled nursing facility (2% to 5.7%). Despite a decrease in the mortality rates, there was no improvement in rate of patients discharged home without assistance over the period of the study.

Conclusions: The results of the present study demonstrate that after hepatic resection, a significant proportion of patients will need assistance upon discharge. This information needs to be included in patient counselling during pre-operative risk and benefit assessment.

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Figures

Figure 1
Figure 1
Trends in discharge disposition over the period of the study
Figure 2
Figure 2
Rate (percentage) of ‘home’ discharge based on age
Figure 3
Figure 3
Rate (percentage) of ‘home’ discharge based on presence of co-morbidities
See this image and copyright information in PMC

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References

    1. Dimick JB, Cowan JA, Jr, Knol JA, Upchurch GR., Jr Hepatic resection in the United States: indications, outcomes and hospital procedural volumes from a nationally representative database. Arch Surg. 2003;138:185–191. - PubMed
    1. Dimick JB, Wainess RM, Cowan JA, Upchurch GR, Jr, Knol JA, Colletti LM. National trends in the use and outcomes of hepatic resection. J Am Coll Surg. 2004;199:31–38. - PubMed
    1. de Jong MC, Pulitano C, Ribero D, Strub J, Mentha G, Schulick RD, et al. Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Ann Surg. 2009;250:440–448. - PubMed
    1. Tomlinson JS, Jarnagin WR, DeMatteo RP, Fong Y, Kornprat P, Gonen M, et al. Actual 10-year survival after resection of colorectal metastasis defines cure. J Clin Oncol. 2007;25:4575–4580. - PubMed
    1. Kopetz S, Chang GJ, Overman MJ, Eng C, Sargent DJ, Larson DW, et al. Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009;27:3677–3683. - PMC - PubMed

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