Risk Factors for 30-day Readmissions after Hepatectomy: Analysis of 2444 Patients from the ACS-NSQIP Database

Abstract

Transfusion, complexity of procedure, and duration of operation were the strongest predictors of unplanned readmissions after liver resection.

Three-point transfusion risk score in hepatectomy

“…Some variation existed in transfusion rates between the derivation and validation cohorts. The RBC transfusion rate reported here (26·5 per cent) is higher than that reported by other studies (17–23 per cent), but includes all RBC transfusions during the patients' hospital stay. All models showed moderate discrimination and good calibration, although they are challenging to interpret and use.…”

“…Perioperative transfusions are reported in 17–23 per cent of patients undergoing hepatectomy. Perioperative red blood cell (RBC) transfusions are associated with poorer outcomes following hepatectomy, including higher risk of morbidity, mortality and cancer recurrence.…”

Use of aspirin and bleeding-related complications after hepatic resection

“…†Data were incomplete for some variables. ‡Common biliary duct resection (153 patients), vascular resection (102), digestive resection (89), pancreatectomy (8), splenectomy (7), abdominal wall procedure (48) and diaphragmatic resection (31). §Vena cava resection (20), hepatic vein resection (9), portal resection (67) and arterial resection (17).…”

Early recovery pathway for hepatectomy: data-driven liver resection care and recovery

“…It is important to consider risk factors and implement safeguards for patients that are more likely to require support in the post-hospital, post-operative setting. For instance, patients who have low baseline albumin, history of vascular disease, receive transfusion within 72 hours of surgery, have excessive intraoperative blood loss, experience any post-operative complications, develop intraabdominal infection, or have longer operative times, are more likely to experience unplanned readmissions (46)(47)(48). Future coordinated efforts are needed to develop a more protocolized approach to score and identify and treat at-risk post-operative patients.…”