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Hospital Readmission Following Surgery for Gastric Cancer: Frequency, Timing, Etiologies, and Survival

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Readmission rates after cancer surgery are infrequently reported, and better understanding of the etiologies for readmission is necessary. We sought to investigate the frequency, timing, and etiologies for hospital readmission after surgery for gastric cancer and whether readmission correlates with clinical outcomes.

Study Design

Hospital readmission was examined through linkage of the California Cancer Registry with the Office of Statewide Health Planning and Development database. Patients with gastric adenocarcinoma who had undergone curative intent surgery between 2000 and 2011 were identified. First readmission within 90 days of initial surgery was analyzed with respect to timing (0–30, 31–60, and 61–90 days) and etiology for readmission. Variables associated with readmission and impact on 5-year overall survival (OS) were examined.

Results

A total of 8887 (male, n = 5326; female, n = 3561) patients underwent curative intent surgery for gastric adenocarcinoma. Within 90 days of initial surgery, 2559 (28.8 %) patients had inpatient hospital readmission. The majority of readmissions occurred in the first 30 days [0–30, n = 1371 (53.6 %); 31–60, n = 773 (30.2 %); and 61–90, n = 415 (16.2 %)]. Readmission vs. no readmission within 90 days correlated with worse 5-year OS in patients with local (51.2 vs. 70.9 %, p < 0.0001) and regional (23.3 vs. 32.9 %, p < 0.0001) disease. On multivariate analysis, readmission within 90 days was associated with worse OS (HR 1.40, 95 % CI 1.32–1.49, p < 0.001).

Conclusions

Hospital readmissions are high after surgery for gastric cancer and correlate with poor patient survival. A better understanding of these issues may allow health care providers to potentially lower readmission rates and improve gastric cancer outcomes.

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Authors and Affiliations

  1. Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA

    Shaila J. Merchant, Philip H. G. Ituarte, Audrey Choi, Byrne Lee & Joseph Kim

  2. Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA

    Joseph Chao

  3. Nursing Research and Education, City of Hope National Medical Center, Duarte, CA, USA

    Virginia Sun

Authors
  1. Shaila J. Merchant
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  2. Philip H. G. Ituarte
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  7. Joseph Kim
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Corresponding author

Correspondence to Joseph Kim.

Appendix

Appendix

Table 6 ICD-9 codes representing principal diagnoses resulting in readmission after surgery for gastric adenocarcinoma
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Merchant, S.J., Ituarte, P.H.G., Choi, A. et al. Hospital Readmission Following Surgery for Gastric Cancer: Frequency, Timing, Etiologies, and Survival. J Gastrointest Surg 19, 1769–1781 (2015). https://doi.org/10.1007/s11605-015-2883-3

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  • DOI: https://doi.org/10.1007/s11605-015-2883-3

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