Association of Hospital Length of Stay and Complications With Readmission After Open Pancreaticoduodenectomy

Jiang, Jerry; Upfill-Brown, Alex; Dann, Amanda M.; Kim, Stephanie S.; Girgis, Mark D.; King, Jonathan C.; Donahue, Timothy R.

doi:10.1001/jamasurg.2018.3213

Cited by 28 publications

(18 citation statements)

References 7 publications

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“…Specifically, while 30‐day mortality and unplanned 30‐day readmission were achieved over 90% of the time, avoiding a prolonged LOS was less common. In an evaluation of the National Surgical Quality Improvement Program (NSQIP) dataset, Jiang et al 25 noted that a LOS >8 days was associated with a higher rate of complications. Other investigators have similarly demonstrated that prolonged LOS following PD functioned as a strong surrogate of postoperative complications 22,26 .…”

Section: Discussionmentioning

confidence: 99%

“…Data on perioperative complications were not reported in the NCDB and therefore the incidence and severity of complications following PD could not be analyzed or included in the TOO definition. To account for this shortcoming, LOS, which has been demonstrated to correlate strongly with occurrence of in‐hospital complications, was included in the TOO definition 22,25,40 . In addition, other factors may have been included in the definition of TOO.…”

Section: Discussionmentioning

confidence: 99%

“…A, Survival curves for survival study population by receipt of textbook oncologic outcome. B, Sensitivity analysis with exclusion of patients with 30-d postoperative mortalityto correlate strongly with occurrence of in-hospital complications, was included in the TOO definition 22,25,40. In addition, other factors may have been included in the definition of TOO.…”

mentioning

confidence: 99%

“…In addition, other factors may have been included in the definition of TOO. The six metrics utilized in the current study have, however, been widely considered in the literature as key elements of quality hospital and oncological care 1,13,14,21,22,[24][25][26][27][28][29]37,40. Additionally, the absence of anatomic or operative variables such as portal venous involvement limited the ability to assess whether patients had borderline resectable disease.…”

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confidence: 99%

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Assessment of textbook oncologic outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma

Sweigert

Eguia

Baker

et al. 2020

Journal of Surgical Oncology

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Background Composite outcomes may more accurately reflect patient and provider expectations around optimal care. We sought to determine the impact of achieving a so‐called “textbook oncologic outcome” (TOO) among patients undergoing resection of pancreatic adenocarcinoma (PDAC). Methods Patients undergoing pancreaticoduodenectomy (PD) for PDAC between 2006 and 2016 were identified in the National Cancer Database (NCDB). TOO was defined by: margin negative resection, compliant lymph node evaluation, no prolonged length‐of‐stay, no 30‐day readmission/mortality, and receipt of adjuvant chemotherapy. Factors associated with TOO and overall survival (OS) were evaluated using multivariable logistic and Cox regression models, respectively. Results Among 18 608 patients who underwent PD at 782 hospitals, many patients successfully achieved certain TOO factors such as R0 margin (77.9%) and no 30‐day mortality (96.9%), while other TOO criteria such as receipt of adjuvant therapy (48.2%) were achieved less frequently. Overall, only 3124 (16.8%) patients achieved a TOO. Factors associated with lower odds of TOO included: older age, Black race, Medicaid insurance, Community facility, and low PD facility (<20 PD/y) (all P < .05). Achievement of a TOO was associated with lower risk of mortality (HR 0.74; 95% CI, 0.70‐0.77). Conclusions While TOO was associated with improved long‐term survival, TOO was only achieved in 16.8% of patients undergoing PD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Assessment of textbook oncologic outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma

Sweigert

Eguia

Baker

et al. 2020

Journal of Surgical Oncology

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“…піталізації, а відповідно й повторної операції, наркозу, післяопераційного періоду, що пов'язане з відповідними для цього ризиками та затратами. Відомо, що при збільшенні часу перебування хворого у стаціонарі з кожним днем збільшується ймовірність госпітальних інфекцій і інших ускладнень, пов'язаних з перебуванням на стаціонарному лікуванні та гіподинамією [4,14]. Також фіксується зростання смертності [21,2].…”

Section: результати обговоренняunclassified

The technique of simultaneous laparoscopic operations in the treatment of gallstone disease and hiatal hernia

Halei¹,

Dzubanovskij²,

Marchuk³

2020

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. Aim of work – to evaluate the quality of medical aid for the regular and simultaneous treatment of patients with gallstone disease in combination with a hiatal hernia. To evaluate the safety of simultaneous operations in the treatment of such patients. Determine advantages and disadvantages of both treatment strategies. Assess the ergonomics of laparoscopic surgery techniques. For sampling the database, statistic collected at the laparoscopic surgery unit of the Volynian Regional Clinical Hospital was used. The number of patients was 332. Patients were formed into two groups: the group of simultaneous laparoscopic treatment (laparoscopic cruroraphy with Toupet fundoplication and laparoscopic cholecystectomy with advanced surgery technique) – the first group of 126 people, and the group with only one operation (laparoscopic cruroraphy) was performed – the second group of 206 patients. The method that was chosen in first group (simultaneous laparoscopic treatment with advanced technique) allowed to prevent re-hospitalization, one more operation, and all associated risks (surgical, anesthesiologycal). Though the cost was a slight increased time of surgery (52 minutes versus 41), as well as a slightly increased the average hospital stay (3.25 days versus 3.1 days) comparing to a single surgery group. Complication rate didn`t increased significantly (5.5% in the first group versus 6.3% in the second group), with zero mortality in both groups. These data allow us to notice the safety and value of this treatment method and to continue its research and testing. The method can be linked to increasing the efficiency of medical care by reducing the number of hospitalizations, the total hospital stay, and reducing the overall cost of treatment, minimizing the cost of dealing with the complications.

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Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation

et al. 2020

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Association of Hospital Length of Stay and Complications With Readmission After Open Pancreaticoduodenectomy

Abstract: had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 28 publications

References 7 publications

Assessment of textbook oncologic outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma

Assessment of textbook oncologic outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma

The technique of simultaneous laparoscopic operations in the treatment of gallstone disease and hiatal hernia

Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation

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