Factors predictive of readmission after hepatic resection for hepatocellular carcinoma

Charles W. Kimbrough, Steven Agle, Charles R. Scoggins, Robert C G Martin, Michael R. Marvin, Eric G. Davis, Kelly M. McMasters, Christopher M. Jones

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background Hepatic resection is associated with substantial morbidity and resource use. To contain costs and improve outcomes, recent health care regulations focus on reducing hospital readmissions while using readmission rates as a quality measure. The goal of this investigation was to characterize the incidence, patterns, and risk factors for readmission after resection for hepatocellular carcinoma. Study design Patient demographics, operative factors, and perioperative outcomes of 245 patients undergoing hepatic resection at an academic center from 2000 to 2012 were reviewed retrospectively. Factors associated for readmission within 90 days of operation were identified through univariate and multivariate logistic regression analysis. Results Forty-six patients (18.7%) required hospital readmission. Univariate analysis identified American Society of Anesthesiologists class, preoperative Model for End-stage Liver Disease score and total bilirubin, preexisting vascular disease, acute renal failure, bile leak, peak postoperative total bilirubin, and intraabdominal infection as factors associated with readmission. Intraabdominal infection, postoperative renal failure, and a history of vascular disease were found to be significant on multivariate analysis. Overall, intraabdominal infection was the strongest predictor for readmission. Conclusion Early readmission after hepatectomy remains relatively common. Postoperative complications and patient comorbidities are the dominant factors in readmission, and we must be mindful of those patients at increased risk for readmission.

Original languageEnglish (US)
Article number3849
Pages (from-to)1039-1048
Number of pages10
JournalSurgery (United States)
Volume156
Issue number4
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

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Hepatocellular Carcinoma
Intraabdominal Infections
Liver
Patient Readmission
Vascular Diseases
Bilirubin
Preexisting Condition Coverage
End Stage Liver Disease
Hepatectomy
Acute Kidney Injury
Bile
Renal Insufficiency
Comorbidity
Multivariate Analysis
Logistic Models
Regression Analysis
Demography
Morbidity
Delivery of Health Care
Costs and Cost Analysis

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Kimbrough, C. W., Agle, S., Scoggins, C. R., Martin, R. C. G., Marvin, M. R., Davis, E. G., ... Jones, C. M. (2014). Factors predictive of readmission after hepatic resection for hepatocellular carcinoma. Surgery (United States), 156(4), 1039-1048. [3849]. https://doi.org/10.1016/j.surg.2014.06.057

Factors predictive of readmission after hepatic resection for hepatocellular carcinoma. / Kimbrough, Charles W.; Agle, Steven; Scoggins, Charles R.; Martin, Robert C G; Marvin, Michael R.; Davis, Eric G.; McMasters, Kelly M.; Jones, Christopher M.

In: Surgery (United States), Vol. 156, No. 4, 3849, 01.10.2014, p. 1039-1048.

Research output: Contribution to journalArticle

Kimbrough, CW, Agle, S, Scoggins, CR, Martin, RCG, Marvin, MR, Davis, EG, McMasters, KM & Jones, CM 2014, 'Factors predictive of readmission after hepatic resection for hepatocellular carcinoma', Surgery (United States), vol. 156, no. 4, 3849, pp. 1039-1048. https://doi.org/10.1016/j.surg.2014.06.057
Kimbrough CW, Agle S, Scoggins CR, Martin RCG, Marvin MR, Davis EG et al. Factors predictive of readmission after hepatic resection for hepatocellular carcinoma. Surgery (United States). 2014 Oct 1;156(4):1039-1048. 3849. https://doi.org/10.1016/j.surg.2014.06.057
Kimbrough, Charles W. ; Agle, Steven ; Scoggins, Charles R. ; Martin, Robert C G ; Marvin, Michael R. ; Davis, Eric G. ; McMasters, Kelly M. ; Jones, Christopher M. / Factors predictive of readmission after hepatic resection for hepatocellular carcinoma. In: Surgery (United States). 2014 ; Vol. 156, No. 4. pp. 1039-1048.
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