Diagnosis of Depression is Associated with Readmission Following Elective Pancreatectomy



Diagnosis of depression may be associated with adverse outcomes following surgery. The aim of this study is to investigate whether depression is associated with an increased readmission rate following elective pancreatectomy, which is currently unknown.


The 2014 Nationwide Readmissions Database was used to evaluate whether diagnosis of depression was associated with 30-day readmission following elective pancreatectomy in adult patients. Univariate and multivariate logistic regression models were adjusted for clustering by facility. A secondary analysis was performed to evaluate whether the risk of diagnosis of depression on 30-day readmission rates was modified by length of stay (median 8 days). All multivariate models were adjusted for patient-level characteristics.


There were an estimated 11,992 patients who underwent elective pancreatectomy. Mean age was 63 years, and 48.9% were male. Approximately 10.2% (n = 1223) had diagnosis of depression. Depression was associated with higher odds of 30-day readmission following elective pancreatectomy on univariate [odds ratio (OR) 1.26, 95% confidence interval (CI) 1.01–1.59; P = 0.043] and multivariate analyses (OR 1.29, 95% CI 1.01–1.65; P = 0.039). Although length of stay > 8 days was independently associated with higher odds of 30-day readmission (P = 0.005), length of stay did not alter the association between diagnosis of depression and odds of readmission (P = 0.90).


Diagnosis of depression was associated with higher odds of 30-day readmission following pancreatectomy, regardless of length of stay. Enhanced focus on evaluation and optimization of perioperative mental health is warranted to identify patients at high risk for readmission and reduce the burden related to readmission following pancreatic surgery.

This is a preview of subscription content, log in to check access.


  1. 1.

    Fisher AV, Fernandes-Taylor S, Campbell-Flohr SA, et al. 30-day Readmission after pancreatic resection: a systematic review of the literature and meta-analysis. Ann Surg. 2017;266:242–50.

    Article  Google Scholar 

  2. 2.

    Hyder O, Dodson RM, Nathan H, et al. Influence of patient, physician, and hospital factors on 30-day readmission following pancreatoduodenectomy in the United States. JAMA Surg 2013;148:1095-1102.

    Article  Google Scholar 

  3. 3.

    Reddy DM, Townsend CM,Jr, Kuo YF, et al. Readmission after pancreatectomy for pancreatic cancer in Medicare patients. J Gastrointest Surg 2009;13:1963-74; discussion 1974-5.

    Article  Google Scholar 

  4. 4.

    Kent TS, Sachs TE, Callery MP, et al. Readmission after major pancreatic resection: a necessary evil? J Am Coll Surg 2011;213:515-523.

    Article  Google Scholar 

  5. 5.

    Brody DJ, Pratt LA, Hughes J. Prevalance of depression among adults aged 20 and over: United States, 2013-2016. NCHS data brief 2018;303. https://www.cdc.gov/nchs/data/databriefs/db303.pdf.

  6. 6.

    Wang J, Wu X, Lai W, et al. Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open 2017;7:e017173.

    Article  Google Scholar 

  7. 7.

    Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 2011;12:160-174.

    Article  Google Scholar 

  8. 8.

    Yli-Kyyny TT, Sund R, Heinanen M, et al. Risk factors for early readmission due to surgical complications after treatment of proximal femoral fractures—a Finnish National Database study of 68,800 patients. Injury 2019;50:403-408.

    Article  Google Scholar 

  9. 9.

    Tully PJ, Baker RA, Turnbull D, et al. The role of depression and anxiety symptoms in hospital readmissions after cardiac surgery. J Behav Med 2008;31:281-290.

    Article  Google Scholar 

  10. 10.

    Kurdyak PA, Gnam WH, Goering P, et al. The relationship between depressive symptoms, health service consumption, and prognosis after acute myocardial infarction: a prospective cohort study. BMC Health Serv Res 2008;8:200.

    Article  Google Scholar 

  11. 11.

    Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Nationwide readmissions database overview. https://www.hcup-us.ahrq.gov/nrdoverview.jsp.

  12. 12.

    Yang L, Zhao Y, Wang Y, et al. The effects of psychological stress on depression. Curr Neuropharmacol 2015;13:494-504.

    CAS  Article  Google Scholar 

  13. 13.

    Bolshinsky V, Li MH, Ismail H, et al. Multimodal prehabilitation programs as a bundle of care in gastrointestinal cancer surgery: a systematic review. Dis Colon Rectum 2018;61:124-138.

    Article  Google Scholar 

  14. 14.

    Luther A, Gabriel J, Watson RP, et al. The impact of total body prehabilitation on post-operative outcomes after major abdominal surgery: a systematic review. World J Surg 2018;42:2781-2791.

    Article  Google Scholar 

  15. 15.

    Li C, Carli F, Lee L, et al. Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study. Surg Endosc 2013;27:1072-1082.

    Article  Google Scholar 

  16. 16.

    Qadan M, Sell N. Pilot study of a multimodal prehabilitation pancreatic cancer program. https://clinicaltrials.gov/ct2/show/NCT03865875. NLM identifier: NCT03865875. Accessed 23 Dec 2019.

Download references


There are no disclosures to report.

Author information



Corresponding author

Correspondence to Motaz Qadan MD, PhD.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 22 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Molina, G., Sell, N.M., Fernández-Del Castillo, C. et al. Diagnosis of Depression is Associated with Readmission Following Elective Pancreatectomy. Ann Surg Oncol 27, 4544–4550 (2020). https://doi.org/10.1245/s10434-020-08522-6

Download citation