Multivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy for XXXX .

@entity1 @entity5 @entity344 @entity281 @entity158
BACKGROUND: Readmission rates after pancreaticoduodenectomy (PD) for @entity5 have a significant impact on survival rate. Identification of risk factors for readmission may improve discharge plans and postoperative care. Data exist on the morbidity and mortality of @entity1 undergoing PD, but there are few reports about hospital readmissions after this procedure. Our aims were to evaluate the proportion and reasons for readmissions after PD for @entity5 , the factors influencing readmissions, and to analyze the relationship between readmission rate and survival rate. METHODS: Four hundred and thirty-six @entity1 , who had undergone PD for @entity5 in our centre from October 1999 to October 2009, a 10-year period, excluding perioperative (30-day) mortality, were identified. All readmissions within 1 year following PD were analyzed with respect to timing, location, reasons for readmission and outcome. We reviewed the hospitalization and readmissions for @entity1 undergoing PD, and compared @entity1 requiring readmission to @entity1 that did not require readmission. RESULTS: One hundred and forty-five @entity1 (33.26%) were readmitted within 1 year following PD, for further treatment or complications. In those cases, diagnoses associated with high rates of readmission included radiation and/or chemotherapy (48.96%), progression of disease (11.72%), @entity281 (11.72%), @entity344 /obstruction (6.20%), surgery-related complications (2.76%) and @entity158 (4.14%). The proportion of T4 in readmission group was lower than no readmission group (P < 0.05). The proportion of node positive cases in readmission group was much higher than no readmission group (P < 0.01). The number of readmission for complications reduced gradually in the first three months, and reached a second peak in the sixth and seventh month. Median survival was lower for the readmission group compared with the no readmission group (21 versus 46 months, P = 0.024). CONCLUSION: These results may assist in both anticipating and facilitating postoperative care as well as managing @entity1 expectations.
