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Hospitalization in the Year Preceding Major Oncologic Surgery Increases Risk for Adverse Postoperative Events.

Abstract：

BACKGROUND:Hospitalization is associated with negative clinical effects that last beyond discharge. This study aimed to determine whether hospitalization in the year before major oncologic surgery is associated with adverse outcomes. METHODS:Patients 18 years of age or older with stomach, pancreas, colon, or rectal cancer who underwent resection in California and New York (2008-2010) were included in the study. Patients with hospitalization in the year prior to oncologic resection (HYPOR) were identified. Multivariable logistic regression was used to examine the association of prior hospitalization with the following adverse outcomes: inpatient mortality, complications, complex discharge needs, and 90-day readmission. Subset analysis by cancer type was performed. Outcomes based on temporal proximity of hospitalization to month of surgical admission were evaluated. RESULTS:Of 32,292 patients, 16.3% (n = 5276) were HYPOR. Patients with prior hospitalization were older (median age, 72 vs 67 years; p < 0.001) and had more comorbidities (Elixhauser Index ≥3, 86.5 vs 75.3%; p < 0.001). In the multivariable analysis, HYPOR was associated with complications (odds ratio [OR], 1.28; 95% confidence interval [CI] 1.18-1.40), complex discharge (OR, 1.44; 95% CI 1.34-1.55), and 90-day readmission (OR, 1.45; 95% CI 1.35-1.56). The interval from HYPOR to resection was not associated with adverse outcomes. CONCLUSIONS:Patients hospitalized in the year before oncologic resection are at increased risk for postoperative adverse events. Recent hospitalization is a risk factor that is easily ascertainable and should be used by clinicians to identify patients who may need additional support around the time of oncologic resection.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Sharoky CE,Collier KT,Wirtalla CJ,Sinnamon AJ,Neuwirth MG,Kuo LE,Roses RE,Fraker DL,Karakousis GC,Kelz RR

doi

10.1245/s10434-017-6032-y

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

3477-3485

issue

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-017-6032-y

journal_volume

pub_type

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Hospitalization in the Year Preceding Major Oncologic Surgery Increases Risk for Adverse Postoperative Events.