Risk factors for 30-day hospital readmission after radical gastrectomy: a single-center retrospective study
- 170 Downloads
Hospital readmission is gathering greater attention as a measure of health care quality. The introduction of fast-track surgery has led to shorter lengths of hospitalization without increasing the risk of postoperative complications and readmission. The collection of comprehensive readmission data is essential for the further improvement of patient care. The aim of the present study is to evaluate the risk factors for readmission within 30 days of discharge after gastrectomy.
A total of 1929 patients who underwent radical gastrectomy at Shizuoka Cancer Center were included in this study. A risk analysis with a stepwise logistic regression model was conducted to identify the risk factors for 30-day hospital readmission.
The 30-day readmission rate was 2.70%. Common causes of readmission were an intolerance of oral intake and the presence of an intra-abdominal abscess. The C reactive protein (CRP) level on postoperative day (POD) 3 was significantly higher in the readmitted group; however, the other surgical outcomes, including the incidence of postoperative complications, did not differ to a statistically significant extent. The stepwise logistic regression analysis revealed that CRP on POD3 ≥ 12 mg/dl [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.09–3.95, p = 0.025], laparoscopic surgery (OR 2.25, 95% CI 1.17–4.31, p = 0.015), and TG (OR 2.23, 95% CI 1.17–4.78, p = 0.023) were found to be independent risk factors for readmission.
CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.
KeywordsHospital readmission Radical gastrectomy Gastric cancer
This work was supported in part by The National Cancer Center Research and Development Fund (29-A-3).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. The ethics committees of SCC (Shizuoka, Japan) reviewed and approved this study (no. 29-J158-29-1-3).
Informed consent or a substitute for it was obtained from all patients before being included in the study.
- 6.Mastracci TM, Cohen Z, Senagore A, Members of the Evidence Based Reviews in Surgery G. Canadian Association of General Surgeons and American College of Surgeons Evidence-Based Reviews in Surgery. 24. Fast-track programs in colonic surgery. Systematic review of enhanced recovery programmes in colonic surgery. Can J Surg. 2008;51(1):70–2.PubMedPubMedCentralGoogle Scholar
- 18.Nomura E, Lee SW, Tokuhara T, Nitta T, Kawai M, Uchiyama K. Functional outcomes according to the size of the gastric remnant and the type of reconstruction following distal gastrectomy for gastric cancer: an investigation including total gastrectomy. Jpn J Clin Oncol. 2013;43(12):1195–202.CrossRefPubMedGoogle Scholar
- 27.Lu W, Gao J, Yang J, Zhang Y, Lv W, Mu J, et al. Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer: a comprehensive systematic review and meta-analysis of randomized control trials. Medicine (Baltimore). 2016;95(27):e3986.CrossRefGoogle Scholar
- 28.Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2016;263(1):28–35.CrossRefPubMedGoogle Scholar
- 30.Kodera Y, Yoshida K, Kumamaru H, Kakeji Y, Hiki N, Etoh T, et al. Introducing laparoscopic total gastrectomy for gastric cancer in general practice: a retrospective cohort study based on a nationwide registry database in Japan. Gastric Cancer. 2018. https://doi.org/10.1007/s10120-018-0795-0.Google Scholar