• Annals of surgery · Aug 2017

    Review Meta Analysis

    30-day Readmission After Pancreatic Resection: A Systematic Review of the Literature and Meta-analysis.

    • Alexander V Fisher, Sara Fernandes-Taylor, Stephanie A Campbell-Flohr, Sam J Clarkson, Emily R Winslow, Daniel E Abbott, and Sharon M Weber.
    • *University of Wisconsin, Department of Surgery, Division of Surgical Oncology, Madison, WI †University of Wisconsin, Department of Surgery, Wisconsin Institute for Surgical Outcomes Research, Madison, WI.
    • Ann. Surg. 2017 Aug 1; 266 (2): 242-250.

    ObjectiveThe aim of this study was to identify and compare common reasons and risk factors for 30-day readmission after pancreatic resection.BackgroundHospital readmission after pancreatic resection is common and costly. Many studies have evaluated this problem and numerous discrepancies exist regarding the primary reasons and risk factors for readmission.MethodsMultiple electronic databases were searched from 2002 to 2016, and 15 relevant articles identified. Overall readmission rate was calculated from individual study estimates using a random-effects model. Study data were combined and overall estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each risk factor. Multivariable data were qualitatively synthesized.ResultsThe overall 30-day readmission rate was 19.1% (95% CI 17.4-20.7) across all studies. Infectious complications and gastrointestinal disorders, such as failure to thrive and delayed gastric emptying, together accounted for 58.9% of all readmissions. Demographic factors did not predict readmission. Heart disease (OR 1.37, 95% CI 1.12-1.67), hypertension (OR 1.44, 95% CI 1.09-1.91), and intraoperative blood transfusion (OR 1.45, 95% CI 1.15-1.83) were weak predictors of readmission, while any postoperative complications (OR 2.22, 95% CI 1.55-3.18) or severe complications (OR 2.84, 95% CI 1.65-4.89) were stronger predictors.ConclusionsReadmission after pancreatic resection is common and can largely be attributed to infectious complications and inability to maintain adequate hydration and nutrition. Focus on outpatient resources and follow-up to address these issues will prove valuable in reducing readmissions.

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