A novel risk scoring system reliably predicts readmission after pancreatectomy

Journal of the American College of Surgeons
Vicente ValeroPancreas Readmission Assessment Group Study

Abstract

Postoperative readmissions have been proposed by Medicare as a quality metric and can impact provider reimbursement. Because readmission after pancreatectomy is common, we sought to identify factors associated with readmission to establish a predictive risk scoring system. A retrospective analysis of 2,360 pancreatectomies performed at 9 high-volume pancreatic centers between 2005 and 2011 was performed. Forty-five factors strongly associated with readmission were identified. To derive and validate a risk scoring system, the population was randomly divided into 2 cohorts in a 4:1 fashion. A multivariable logistic regression model was constructed and scores were assigned based on the relative odds ratio (OR) of each independent predictor. A composite Readmission after Pancreatectomy (RAP) score was generated and then stratified to create risk groups. Overall, 464 (19.7%) patients were readmitted within 90 days. Eight pre- and postoperative factors, including earlier MI (OR = 2.03), American Society of Anesthesiologists class ≥ 3 (OR = 1.34), dementia (OR = 6.22), hemorrhage (OR = 1.81), delayed gastric emptying (OR = 1.78), surgical site infection (OR = 3.31), sepsis (OR = 3.10), and short length of stay (OR = 1.51) were indepen...Continue Reading

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Citations

Mar 10, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Dimitrios XourafasStanley W Ashley
Sep 20, 2015·American Journal of Surgery·Caitlin W HicksChristopher L Wolfgang
Sep 7, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Russell C KirksDionisios Vrochides
Mar 23, 2019·Journal of Hepato-biliary-pancreatic Sciences·Heather PelusoMarwan S Abougergi
Jul 25, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Dimitrios XourafasTimothy M Pawlik
Feb 28, 2018·Journal of Surgical Oncology·Carl R SchmidtSusan White
May 6, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Florence E TurrentineVictor M Zaydfudim
Nov 4, 2015·Journal of Visceral Surgery·L GauduchonJ M Regimbeau
Jul 28, 2018·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Amanda P C S BoteonRobert P Sutcliffe
Aug 6, 2018·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jason B LiuHenry A Pitt

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