Risk Factors for 30-day Readmissions after Hepatectomy: Analysis of 2444 Patients from the ACS-NSQIP Database

被引:19
|
作者
Kim, Sooyeon [1 ]
Maynard, Erin C. [1 ]
Shah, Malay B. [1 ]
Daily, Michael F. [1 ]
Tzeng, Ching-Wei D. [2 ]
Davenport, Daniel L. [3 ]
Gedaly, Roberto [1 ]
机构
[1] Univ Kentucky, Coll Med, Dept Surg, Sect Transplant Surg, Lexington, KY 40508 USA
[2] Univ Kentucky, Coll Med, Dept Surg, Sect Surg Oncol, Lexington, KY 40508 USA
[3] Univ Kentucky, Coll Med, Dept Surg, Lexington, KY 40508 USA
关键词
Hepatectomy; Liver resection; Readmission; LIVER RESECTION; MULTICENTER ANALYSIS; HEPATIC RESECTION; MORTALITY; SURGERY; PROGRAM; TRENDS;
D O I
10.1007/s11605-014-2713-z
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The aim of this study was to identify risk factors associated with unplanned readmissions after hepatectomies. Patients who underwent hepatectomies between January and December of 2011 were identified using the ACS-NSQIP database. A multivariate logistic regression analysis was performed to determine predictors of unplanned readmissions related to the procedure within 30 days. Unplanned readmissions occurred in 10.5 % of all patients who received a hepatectomy. On multivariate analysis, transfusion within 72 h after surgery (odds ratio [OR] 1.74, p < 0.001), complexity of procedure (extended, OR 1.84, p = 0.004; right hepatectomy, OR 1.66, p = 0.003), and longer operative time (> median 320 min, OR 2.43, p < 0.001) were independent perioperative predictors of unplanned readmissions. Independent preoperative risk factors included elevated alkaline phosphatase (OR 1.45, p = 0.017), bleeding disorders (OR 1.72, p = 0.051), and lower albumin levels (OR 1.30, p = 0.036). Transfusion, complexity of procedure, and duration of operation were the strongest predictors of unplanned readmissions after liver resection.
引用
收藏
页码:266 / 271
页数:6
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