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Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer

Unplanned readmissions heavily affect the cost of health care and are used as an indicator of performance. No clear data are available regarding beyond-total mesorectal excision (bTME) procedure. Aim of the study is to identify patient-related and surgery-related factors influencing the 30-day readm...

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Autores principales: Liccardo, Filomena, Baird, Daniel L. H., Pellino, Gianluca, Rasheed, Shahnawaz, Kontovounisios, Christos, Tekkis, Paris P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686032/
https://www.ncbi.nlm.nih.gov/pubmed/31250396
http://dx.doi.org/10.1007/s13304-019-00669-6
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author Liccardo, Filomena
Baird, Daniel L. H.
Pellino, Gianluca
Rasheed, Shahnawaz
Kontovounisios, Christos
Tekkis, Paris P.
author_facet Liccardo, Filomena
Baird, Daniel L. H.
Pellino, Gianluca
Rasheed, Shahnawaz
Kontovounisios, Christos
Tekkis, Paris P.
author_sort Liccardo, Filomena
collection PubMed
description Unplanned readmissions heavily affect the cost of health care and are used as an indicator of performance. No clear data are available regarding beyond-total mesorectal excision (bTME) procedure. Aim of the study is to identify patient-related and surgery-related factors influencing the 30-day readmissions after bTME. Retrospective data were collected from 220 patients who underwent bTME procedures at single centre between 2006 and 2016. Patient-related and operative factors were assessed, including body mass index (BMI), age, gender, American Society of Anaesthesiologists’ (ASA) score, preoperative stage, neo-adjuvant therapy, primary tumour vs recurrence, the extent of surgery. The readmission rate was 8.18%. No statistically significant association was found with BMI, ASA score, length of stay and stay in the intensive care unit, primary vs recurrent tumour or blood transfusions. Not quite statistically significant was the association with pelvic side wall dissection (OR 3.32, p = 0.054). Statistically significant factors included preoperative stage > IIIb (OR: 4.77, p = 0.002), neo-adjuvant therapy (OR: 0.13, p = 0.0006), age over 65 years (OR: 5.96, p = 0.0005), any re-intervention during the first admission (OR: 7.4, p = 0.0001), and any post-operative complication (OR: 9.01, p = 0.004). The readmission rate after beyond-TME procedure is influenced by patient-related factors as well as post-operative morbidity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13304-019-00669-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-66860322019-08-23 Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer Liccardo, Filomena Baird, Daniel L. H. Pellino, Gianluca Rasheed, Shahnawaz Kontovounisios, Christos Tekkis, Paris P. Updates Surg Original Article Unplanned readmissions heavily affect the cost of health care and are used as an indicator of performance. No clear data are available regarding beyond-total mesorectal excision (bTME) procedure. Aim of the study is to identify patient-related and surgery-related factors influencing the 30-day readmissions after bTME. Retrospective data were collected from 220 patients who underwent bTME procedures at single centre between 2006 and 2016. Patient-related and operative factors were assessed, including body mass index (BMI), age, gender, American Society of Anaesthesiologists’ (ASA) score, preoperative stage, neo-adjuvant therapy, primary tumour vs recurrence, the extent of surgery. The readmission rate was 8.18%. No statistically significant association was found with BMI, ASA score, length of stay and stay in the intensive care unit, primary vs recurrent tumour or blood transfusions. Not quite statistically significant was the association with pelvic side wall dissection (OR 3.32, p = 0.054). Statistically significant factors included preoperative stage > IIIb (OR: 4.77, p = 0.002), neo-adjuvant therapy (OR: 0.13, p = 0.0006), age over 65 years (OR: 5.96, p = 0.0005), any re-intervention during the first admission (OR: 7.4, p = 0.0001), and any post-operative complication (OR: 9.01, p = 0.004). The readmission rate after beyond-TME procedure is influenced by patient-related factors as well as post-operative morbidity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13304-019-00669-6) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-06-27 2019 /pmc/articles/PMC6686032/ /pubmed/31250396 http://dx.doi.org/10.1007/s13304-019-00669-6 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Liccardo, Filomena
Baird, Daniel L. H.
Pellino, Gianluca
Rasheed, Shahnawaz
Kontovounisios, Christos
Tekkis, Paris P.
Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
title Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
title_full Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
title_fullStr Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
title_full_unstemmed Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
title_short Predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
title_sort predictors of short-term readmission after beyond total mesorectal excision for primary locally advanced and recurrent rectal cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686032/
https://www.ncbi.nlm.nih.gov/pubmed/31250396
http://dx.doi.org/10.1007/s13304-019-00669-6
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