Abstract:
BACKGROUND:Readmission rates of 9.7% to 15.5% after hepatectomy have been reported. These rates are difficult to interpret due to variability in the time interval used to monitor readmission. The aim of this study was to refine the definition of readmission after hepatectomy. STUDY DESIGN:A prospectively maintained database of 3,041 patients who underwent hepatectomy from 1998 through 2013 was merged with the hospital registry to identify readmissions. Area under the curve (AUC) analysis was used to determine the time interval that best captured unplanned readmission. RESULTS:Readmission rates at 30 days, 90 days, and 1 year after discharge were 10.7% (n = 326), 17.3% (n = 526), and 31.9% (n = 971) respectively. The time interval that best accounted for unplanned readmissions was 45 days after discharge (AUC, 0.956; p < 0.001), during which 389 patients (12.8%) were readmitted (unplanned: n = 312 [10.3%]; planned: n = 77 [2.5%]). In comparison, the 30 days after surgery interval (used in the ACS-NSQIP database) omitted 65 (26.3%) unplanned readmissions. Multivariate analysis revealed the following risk factors for unplanned readmission: diabetes (odds ratio [OR] 1.6; p = 0.024), right hepatectomy (OR 2.1; p = 0.034), bile duct resection (OR 1.9; p = 0.034), abdominal complication (OR 1.8; p = 0.010), and a major postoperative complication (OR 2.4; p < 0.001). Neither index hospitalization > 7 days nor postoperative hepatobiliary complications were independently associated with readmission. CONCLUSIONS:To accurately assess readmission after hepatectomy, patients should be monitored 45 days after discharge.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Brudvik KW,Mise Y,Conrad C,Zimmitti G,Aloia TA,Vauthey JNdoi
10.1016/j.jamcollsurg.2015.01.063subject
Has Abstractpub_date
2015-07-01 00:00:00pages
38-46issue
1eissn
1072-7515issn
1879-1190pii
S1072-7515(15)00159-3journal_volume
221pub_type
杂志文章abstract:BACKGROUND:The clinicopathologic characteristics and the expression of apomucin (MUC) in intrahepatic cholangiocarcinoma (ICC) with respect to gross morphology have not been comprehensively examined. STUDY DESIGN:We reviewed the clinical data of 98 patients with ICC who underwent resection at Seoul National University...
journal_title:Journal of the American College of Surgeons
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更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Sepsis from bloodstream infection (BSI) is an important cause of morbidity and mortality among surgical patients. Our hypothesis was that fever and leukocytosis during BSI would be associated with gram-negative pathogens and worse outcomes among hospitalized surgical patients. STUDY DESIGN:A prospectively c...
journal_title:Journal of the American College of Surgeons
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abstract:BACKGROUND:In the past, type 2 (C-peptide positive) diabetes mellitus (DM) was a contraindication for simultaneous pancreas-kidney transplantation (SPKT). STUDY DESIGN:We retrospectively analyzed outcomes in SPKT recipients according to pretransplantation C-peptide levels ≥ 2.0 ng/mL or < 2.0 ng/mL. RESULTS:From Nove...
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journal_title:Journal of the American College of Surgeons
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更新日期:1994-03-01 00:00:00
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更新日期:2020-08-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Interleukin-6 (IL-6) plays a central role in the acute phase of inflammation after surgical injury. The serum concentration of IL-6 increases during an operation. The mechanisms of this increase in the serum IL-6 level, however, has not yet been fully clarified. STUDY DESIGN:To determine the possibility of ...
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doi:
更新日期:1994-09-01 00:00:00
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doi:
更新日期:1995-09-01 00:00:00
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doi:10.1016/j.jamcollsurg.2004.03.025
更新日期:2004-08-01 00:00:00
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更新日期:2004-11-01 00:00:00
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更新日期:2001-08-01 00:00:00
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更新日期:2002-10-01 00:00:00
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更新日期:2005-06-01 00:00:00