Comparison of demographic variables related to 30-day readmission in cancers with similar risk factors: Analysis of 290,270 hospitalizations.

Abstract

e15596 Background: There has been increasing focus on reducing hospital readmissions which are an ongoing economic challenge. This study was targeted at cancer of the esophagus (CE), stomach (CS), and pancreas (CP) which share similar risk factors to identify if these patient subsets also share risk for hospital readmission. Methods: Data was extracted from Nationwide Inpatient Sample database, which approximates 20% of U.S. community hospitals. Patients with a diagnosis CE, CS, and CP were identified by Clinical Classification Software code 11, 12, and 17, respectively. Demographic parameters associated with high readmission rates were collected for patients readmitted within 30 days over 2009-2013. Chi-square test was used to asses differences between variables. Results: We identified a total of 290,270 hospitalizations over the 5-year period of which 26.2% were readmitted within 30 days. The total number of readmissions were comparable for CS (28.0%), CP (27.89%), and CE (26.81%). Patients 45 to 64 years (28.58%, p < 0.001), Medicaid insurances (33.4%, p < 0.001), and metropolitan areas (26.8%, p < 0.001) were associated with higher 30-day readmission rates amongst all three cancers. Males had higher readmission rates in CS (25.64%, p < 0.001) and CP (28.6%, p < 0.001) compared to females in CE (28.0%, p < 0.001). Lowest median income for zip code patients were readmitted more often in CS (26.2%, p < 0.001) vs. third median income in CP (27.78, p < 0.001) and fourth (highest) median income in CE (28.38 %, p < 0.001). The most common identified causes of readmission in all three cancers were complications of surgical procedures or medical care (8.51% ± 2.03%), and septicemia (6.5% ± 1.95%). Conclusions: Our analysis shows that some variables for readmission are similar however more studies are needed to further elucidate whether this is primarily due to analogous treatment techniques. If so interventions to limit readmissions related to these treatments should be taken. Differences in readmissions rate amongst income classes could be related to the ease of accessing the most endorsed treatments for each individual cancer, however further studies are needed to clarify this discrepancy.

Risk factors of the postoperative 30-day readmission of gastric cancer surgery after discharge

“…[ 6 , 7 ] The reported postoperative 30-day readmission rate of patients who underwent surgical treatment has ranged from 6.8% to 18.2%. [ 7 – 10 ] Different types of operations have different readmission rates; Sivsammye and Kailasam [ 11 ] reported that the 30-day readmission rates were 28.0% for esophageal cancer and 27.9% for pancreatic cancer after surgical treatment. The reported 30-day readmission rate of gastric cancer surgery has ranged from 2.7% to 16.5%.…”