Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;150(2):152-8.
doi: 10.1001/jamasurg.2014.2346.

Tracking early readmission after pancreatectomy to index and nonindex institutions: a more accurate assessment of readmission

Jeffrey J Tosoian  1 , Caitlin W Hicks  1 , John L Cameron  1 , Vicente Valero 3rd  1 , Frederic E Eckhauser  1 , Kenzo Hirose  1 , Martin A Makary  1 , Timothy M Pawlik  1 , Nita Ahuja  1 , Matthew J Weiss  1 , Christopher L Wolfgang  1
Affiliations

Tracking early readmission after pancreatectomy to index and nonindex institutions: a more accurate assessment of readmission

Jeffrey J Tosoian et al. JAMA Surg. 2015 Feb.

Abstract

Importance: Readmission after pancreatectomy is common, but few data compare patterns of readmission to index and nonindex hospitals.

Objectives: To evaluate the rate of readmission to index and nonindex institutions following pancreatectomy at a tertiary high-volume institution and to identify patient-level factors predictive of those readmissions.

Design, setting, and participants: Retrospective analysis of a prospectively collected institutional database linked to statewide data of patients who underwent pancreatectomy at a tertiary care referral center between January 1, 2005, and December 2, 2010.

Exposure: Pancreatectomy.

Main outcomes and measures: The primary outcome was unplanned 30-day readmission to index or nonindex hospitals. Risk factors and reasons for readmission were measured and compared by site using univariable and multivariable analyses.

Results: Among all 623 patients who underwent pancreatectomy during the study period, 134 (21.5%) were readmitted to our institution (105 [78.4%]) or to an outside institution (29 [21.6%]). Fifty-six patients (41.8%) were readmitted because of a gastrointestinal or nutritional problem related to surgery and 42 patients (31.3%) because of a postoperative infection. On multivariable analysis, factors independently associated with readmission included age 65 years or older (odds ratio [OR], 1.80; 95% CI, 1.19-2.71), preexisting liver disease (OR, 2.28; 95% CI, 1.23-4.24), distal pancreatectomy (OR, 1.77; 95% CI, 1.11-2.84), and postoperative drain placement (OR, 2.81; 95% CI, 1.00-7.14).

Conclusions and relevance: In total, 21.5% of patients required early readmission after pancreatectomy. Even in the setting of a tertiary care referral center, 21.6% of these readmissions were to nonindex institutions. Specific patient-level factors were associated with an increased risk of readmission.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors have no disclosures.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Weinberger M, Oddone EZ, Henderson WG. Does increased access to primary care reduce hospital readmissions? veterans affairs cooperative study group on primary care and hospital readmission. N Engl J Med. 1996;334(22):1441–1447. - PubMed
    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the medicare fee-for-service program. N Engl J Med. 2009;360(14):1418–1428. - PubMed
    1. Agency for Healthcare Research and Quality (AHRQ) Facts and figures 2009 - section 3 table of contents. healthcare cost and utilization project (HCUP) [Accessed 07/28, 2013]; http://www.hcup-us.ahrq.gov/reports/factsandfigures/2009/section3_TOC.jsp.
    1. Centers for Medicare and Medicaid Services (CMS) Readmissions reduction program. [Accessed 07/28, 2013]; http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpati....
    1. Centers for Medicare and Medicaid Services (CMS) Hospital value-based purchasing. [Accessed 01/28, 2014]; http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instr....