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The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study

Background: Unplanned hospital visits (UHV) and readmissions after pancreaticoduodenectomy (PD) impact patients’ postoperative recovery and are associated with increased financial burden and morbidity. The aim of this study is to identify predictive factors related to these events and target the pot...

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Autores principales: Kou, Hao-Wei, Hsu, Chih-Po, Chen, Yi-Fu, Huang, Jen-Fu, Chang, Shih-Chun, Lee, Chao-Wei, Wang, Shang-Yu, Yeh, Chun-Nan, Yeh, Ta-Sen, Hwang, Tsann-Long, Hsu, Jun-Te
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775671/
https://www.ncbi.nlm.nih.gov/pubmed/35052290
http://dx.doi.org/10.3390/healthcare10010126
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author Kou, Hao-Wei
Hsu, Chih-Po
Chen, Yi-Fu
Huang, Jen-Fu
Chang, Shih-Chun
Lee, Chao-Wei
Wang, Shang-Yu
Yeh, Chun-Nan
Yeh, Ta-Sen
Hwang, Tsann-Long
Hsu, Jun-Te
author_facet Kou, Hao-Wei
Hsu, Chih-Po
Chen, Yi-Fu
Huang, Jen-Fu
Chang, Shih-Chun
Lee, Chao-Wei
Wang, Shang-Yu
Yeh, Chun-Nan
Yeh, Ta-Sen
Hwang, Tsann-Long
Hsu, Jun-Te
author_sort Kou, Hao-Wei
collection PubMed
description Background: Unplanned hospital visits (UHV) and readmissions after pancreaticoduodenectomy (PD) impact patients’ postoperative recovery and are associated with increased financial burden and morbidity. The aim of this study is to identify predictive factors related to these events and target the potentially preventable UHV and readmissions. Methods: We enrolled 518 patients in this study. Characteristics were compared between patients with or without UHV and readmissions. Results: The unplanned visit and readmission rate was 23.4% and 15.8%, respectively. Postoperative pancreatic fistula (POPF) grade B or C, the presence of postoperative biliary drainage, and reoperation were found to be predictive factors for UHV, whereas POPF grade B or C and the presence of postoperative biliary drainage were independently associated with hospital readmission. The most common reason for readmission was an infection, followed by failure to thrive. The overall mortality rate in the readmission group was 4.9%. Conclusions: UHV and readmissions remain common among patients undergoing PD. Patients with grade B or C POPF assessed during index hospitalization harbor an approximately two-fold increased risk of subsequent unplanned visits or readmissions compared to those with no POPF or biochemical leak. Proper preventive strategies should be adopted for high-risk patients in this population to maintain the continuum of healthcare and improve quality.
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spelling pubmed-87756712022-01-21 The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study Kou, Hao-Wei Hsu, Chih-Po Chen, Yi-Fu Huang, Jen-Fu Chang, Shih-Chun Lee, Chao-Wei Wang, Shang-Yu Yeh, Chun-Nan Yeh, Ta-Sen Hwang, Tsann-Long Hsu, Jun-Te Healthcare (Basel) Article Background: Unplanned hospital visits (UHV) and readmissions after pancreaticoduodenectomy (PD) impact patients’ postoperative recovery and are associated with increased financial burden and morbidity. The aim of this study is to identify predictive factors related to these events and target the potentially preventable UHV and readmissions. Methods: We enrolled 518 patients in this study. Characteristics were compared between patients with or without UHV and readmissions. Results: The unplanned visit and readmission rate was 23.4% and 15.8%, respectively. Postoperative pancreatic fistula (POPF) grade B or C, the presence of postoperative biliary drainage, and reoperation were found to be predictive factors for UHV, whereas POPF grade B or C and the presence of postoperative biliary drainage were independently associated with hospital readmission. The most common reason for readmission was an infection, followed by failure to thrive. The overall mortality rate in the readmission group was 4.9%. Conclusions: UHV and readmissions remain common among patients undergoing PD. Patients with grade B or C POPF assessed during index hospitalization harbor an approximately two-fold increased risk of subsequent unplanned visits or readmissions compared to those with no POPF or biochemical leak. Proper preventive strategies should be adopted for high-risk patients in this population to maintain the continuum of healthcare and improve quality. MDPI 2022-01-08 /pmc/articles/PMC8775671/ /pubmed/35052290 http://dx.doi.org/10.3390/healthcare10010126 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kou, Hao-Wei
Hsu, Chih-Po
Chen, Yi-Fu
Huang, Jen-Fu
Chang, Shih-Chun
Lee, Chao-Wei
Wang, Shang-Yu
Yeh, Chun-Nan
Yeh, Ta-Sen
Hwang, Tsann-Long
Hsu, Jun-Te
The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study
title The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study
title_full The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study
title_fullStr The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study
title_full_unstemmed The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study
title_short The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study
title_sort severity of postoperative pancreatic fistula predicts 30-day unplanned hospital visit and readmission after pancreaticoduodenectomy: a single-center retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775671/
https://www.ncbi.nlm.nih.gov/pubmed/35052290
http://dx.doi.org/10.3390/healthcare10010126
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