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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

TEJOS S., Rodrigo et al. Hospital readmission rates after hepatic and pancreatic resections. Rev Chil Cir [online]. 2018, vol.70, n.4, pp.329-335. ISSN 0718-4026.  http://dx.doi.org/10.4067/s0718-40262018000300329.

Aim:

To determine readmission rates and its associated factors in patients undergoing pancreatic and hepatic resections at our center.

Matherial and Methods:

Perioperative variables of patients undergoing pancreatic and hepatic resections between 2012-2014 were reviewed. Demographic and perioepartive data, as well as up —to postoperative day 30— readmisson rates were analyzed. Emergency cases, postoperative mortality and/or patients undergoing less extensive surgery (less than 2 Couinaud's segments, non-anatomical resections and non resective cases such as bilioenteric anastomoses) were excluded. Readmission associated factors were identified using both univariate (χ2 for categorical and t-student's/Mann-Whitney for continuous variables) and multivariate (logistic regression) analysis.

Results:

116 cases were included, 50.9 % female. Mean postoperative stay was 14 days. Pancreatic adenocarcinoma was the most frequent diagnosis (25.9%), and the 40.5% of surgical procedures were pancreaticoduodenectomy. Overall 30-day readmission rate was 18.1%, with a 23.7% for pancreatic resections and 12.2% for hepatic resections. According to univariate analysis; readmission associated factors were: pancreatic resection, preoperative White cell count, the development of postoperative complications and postoperative length of stay. On Multivariate analysis only postoperative stay was the only significant associate factor [OR 1,2 CI 95% 1.1- 1.5 (p = 0.001)].

Conclussion:

Readmission rates after pancreatic and hepatic resections are elevated, even in high-volume centers. Postoperative length of stay is a consistent risk factor for readmission after these type of surgeries. We highly recommend including this parameter as a quality marker of our surgical results in our country.

Palabras clave : patient readmission; pancreas; pancreatectomy; pancreaticoduodenectomy; hepatectomy.

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