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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MDPI AG
2022-01-01
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| Online Access: | https://www.mdpi.com/2227-9032/10/1/126 |
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| author | Hao-Wei Kou Chih-Po Hsu Yi-Fu Chen Jen-Fu Huang Shih-Chun Chang Chao-Wei Lee Shang-Yu Wang Chun-Nan Yeh Ta-Sen Yeh Tsann-Long Hwang Jun-Te Hsu |
| author_facet | Hao-Wei Kou Chih-Po Hsu Yi-Fu Chen Jen-Fu Huang Shih-Chun Chang Chao-Wei Lee Shang-Yu Wang Chun-Nan Yeh Ta-Sen Yeh Tsann-Long Hwang Jun-Te Hsu |
| author_sort | Hao-Wei Kou |
| collection | DOAJ |
| 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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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T01:22:36Z |
| publishDate | 2022-01-01 |
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| series | Healthcare |
| spelling | doaj.art-14b98ce376474852bba31207ab2e50d52023-11-23T13:56:09ZengMDPI AGHealthcare2227-90322022-01-0110112610.3390/healthcare10010126The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort StudyHao-Wei Kou0Chih-Po Hsu1Yi-Fu Chen2Jen-Fu Huang3Shih-Chun Chang4Chao-Wei Lee5Shang-Yu Wang6Chun-Nan Yeh7Ta-Sen Yeh8Tsann-Long Hwang9Jun-Te Hsu10Department of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanDepartment of Surgery, Division of General Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, TaiwanBackground: 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.https://www.mdpi.com/2227-9032/10/1/126pancreaticoduodenectomypancreatic fistulaunplanned hospital visitreadmission |
| spellingShingle | Hao-Wei Kou Chih-Po Hsu Yi-Fu Chen Jen-Fu Huang Shih-Chun Chang Chao-Wei Lee Shang-Yu Wang Chun-Nan Yeh Ta-Sen Yeh Tsann-Long Hwang Jun-Te Hsu The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study Healthcare pancreaticoduodenectomy pancreatic fistula unplanned hospital visit readmission |
| 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 | pancreaticoduodenectomy pancreatic fistula unplanned hospital visit readmission |
| url | https://www.mdpi.com/2227-9032/10/1/126 |
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