• Eric B Schneider, Joseph K Canner, Faiz Gani, Yuhree Kim, Aslam Ejaz, Gaya Spolverato, and Timothy M Pawlik.
• Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
• J. Surg. Res. 2015 Jun 1; 196 (1): 74-81.

BackgroundMost studies focus on readmission within 30 d of surgery and may therefore underestimate the true burden of readmission after complex procedures. We therefore sought to explore factors associated with readmission within 90 d of discharge after pancreaticoduodenectomy (PD).MethodsPatients discharged after PD between 2010 and 2012 were identified from the Truven Health MarketScan database. Determinants of early (≤30 d) and late (31-90 d) readmission were identified and analyzed.ResultsA total of 2209 patients met inclusion criteria with 615 patients being readmitted within 90 d; 20.37% (n = 450) had an early readmission, whereas 7.47% (n = 165) had a late readmission. Patients readmitted early had a longer length-of-stay (LOS) for the readmission compared with patients readmitted late (median LOS = 5 d, interquartile range, 3-8 versus median LOS = 3 d, interquartile range, 2-5, P < 0.001). Common causes for readmission differed between these two patient groups. On multivariable analysis, postoperative complications (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.16-1.84, P < 0.001), an extended LOS (OR 1.34, CI 1.05-1.71, P = 0.019), and the presence of preexisting coronary heart disease (OR 1.82, CI 1.09-3.01, P = 0.020) or renal disease (OR 2.15, CI 1.01-4.61, P = 0.048) were associated with an early readmission. No patient- or procedure-related factors were associated with late readmission.ConclusionsReadmission within 30 d after PD was associated with patient- and procedure-related factors. Readmission in the 31-90-d window was not associated with patient- or procedure-related factors and may be influenced by the underlying pathology or subsequent medical management for that disease.Copyright © 2015 Elsevier Inc. All rights reserved.

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