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Short-term and intermediate-term readmission after esophagectomy

BACKGROUND: The objective of this study was to characterize short- and intermediate-term readmissions following esophagectomy and to identify predictors of readmission in these two groups. METHODS: Patients who underwent esophagectomy in the National Readmissions Database (2013–2014) were grouped ac...

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Autores principales: Wang, Yoyo, Yang, Chi-Fu Jeffrey, He, Hao, Buchan, Josephine M., Patel, Deven C., Liou, Douglas Z., Lui, Natalie S., Berry, Mark F., Shrager, Joseph B., Backhus, Leah M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411130/
https://www.ncbi.nlm.nih.gov/pubmed/34527309
http://dx.doi.org/10.21037/jtd-21-637
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author Wang, Yoyo
Yang, Chi-Fu Jeffrey
He, Hao
Buchan, Josephine M.
Patel, Deven C.
Liou, Douglas Z.
Lui, Natalie S.
Berry, Mark F.
Shrager, Joseph B.
Backhus, Leah M.
author_facet Wang, Yoyo
Yang, Chi-Fu Jeffrey
He, Hao
Buchan, Josephine M.
Patel, Deven C.
Liou, Douglas Z.
Lui, Natalie S.
Berry, Mark F.
Shrager, Joseph B.
Backhus, Leah M.
author_sort Wang, Yoyo
collection PubMed
description BACKGROUND: The objective of this study was to characterize short- and intermediate-term readmissions following esophagectomy and to identify predictors of readmission in these two groups. METHODS: Patients who underwent esophagectomy in the National Readmissions Database (2013–2014) were grouped according to whether first readmission was “short-term” (readmitted <30 days) or “intermediate-term” (readmitted 31–90 days) following index admission for esophagectomy. Predictors of readmission were evaluated using multivariable logistic regression modeling. RESULTS: Of the 3,005 patients who underwent esophagectomy, 544 (18.1%) had a short-term readmission and 305 (10.1%) had an intermediate-term readmission. The most frequent reasons for short-term readmission were post-operative infection (7.5%), dysphagia (6.3%) and pneumonia (5.1%). The most common intermediate-term complications were pneumonia (7.2%), gastrointestinal stricture/stenosis (6.9%) and dysphagia (5.9%). In multivariable analysis, being located in a micropolitan area, increasing number of comorbidities and higher severity of illness score were associated with an increased likelihood of having a short-term readmission while being discharged to a facility (as opposed to directly home) was associated with increased likelihood of both short- and intermediate-term readmission (all P<0.05). CONCLUSIONS: In this analysis, postoperative infection was the most common reason for short-term readmission. Dysphagia and pneumonia were common reasons for both short- and intermediate-term readmission of patients following esophagectomy. Interventions focused on reducing the risk of postoperative infection and pneumonia may reduce hospital readmissions. Gastrointestinal stricture and dysphagia were associated with increased risk of intermediate readmission and should be examined in the context of morbidity associated with pyloric procedures (e.g., pyloromyotomy) at the time of esophagectomy.
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spelling pubmed-84111302021-09-14 Short-term and intermediate-term readmission after esophagectomy Wang, Yoyo Yang, Chi-Fu Jeffrey He, Hao Buchan, Josephine M. Patel, Deven C. Liou, Douglas Z. Lui, Natalie S. Berry, Mark F. Shrager, Joseph B. Backhus, Leah M. J Thorac Dis Original Article BACKGROUND: The objective of this study was to characterize short- and intermediate-term readmissions following esophagectomy and to identify predictors of readmission in these two groups. METHODS: Patients who underwent esophagectomy in the National Readmissions Database (2013–2014) were grouped according to whether first readmission was “short-term” (readmitted <30 days) or “intermediate-term” (readmitted 31–90 days) following index admission for esophagectomy. Predictors of readmission were evaluated using multivariable logistic regression modeling. RESULTS: Of the 3,005 patients who underwent esophagectomy, 544 (18.1%) had a short-term readmission and 305 (10.1%) had an intermediate-term readmission. The most frequent reasons for short-term readmission were post-operative infection (7.5%), dysphagia (6.3%) and pneumonia (5.1%). The most common intermediate-term complications were pneumonia (7.2%), gastrointestinal stricture/stenosis (6.9%) and dysphagia (5.9%). In multivariable analysis, being located in a micropolitan area, increasing number of comorbidities and higher severity of illness score were associated with an increased likelihood of having a short-term readmission while being discharged to a facility (as opposed to directly home) was associated with increased likelihood of both short- and intermediate-term readmission (all P<0.05). CONCLUSIONS: In this analysis, postoperative infection was the most common reason for short-term readmission. Dysphagia and pneumonia were common reasons for both short- and intermediate-term readmission of patients following esophagectomy. Interventions focused on reducing the risk of postoperative infection and pneumonia may reduce hospital readmissions. Gastrointestinal stricture and dysphagia were associated with increased risk of intermediate readmission and should be examined in the context of morbidity associated with pyloric procedures (e.g., pyloromyotomy) at the time of esophagectomy. AME Publishing Company 2021-08 /pmc/articles/PMC8411130/ /pubmed/34527309 http://dx.doi.org/10.21037/jtd-21-637 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Wang, Yoyo
Yang, Chi-Fu Jeffrey
He, Hao
Buchan, Josephine M.
Patel, Deven C.
Liou, Douglas Z.
Lui, Natalie S.
Berry, Mark F.
Shrager, Joseph B.
Backhus, Leah M.
Short-term and intermediate-term readmission after esophagectomy
title Short-term and intermediate-term readmission after esophagectomy
title_full Short-term and intermediate-term readmission after esophagectomy
title_fullStr Short-term and intermediate-term readmission after esophagectomy
title_full_unstemmed Short-term and intermediate-term readmission after esophagectomy
title_short Short-term and intermediate-term readmission after esophagectomy
title_sort short-term and intermediate-term readmission after esophagectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411130/
https://www.ncbi.nlm.nih.gov/pubmed/34527309
http://dx.doi.org/10.21037/jtd-21-637
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