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Examining reoperation and readmission after hepatic surgery.

Publication ,  Journal Article
Barbas, AS; Turley, RS; Mallipeddi, MK; Lidsky, ME; Reddy, SK; White, RR; Clary, BM
Published in: J Am Coll Surg
May 2013

BACKGROUND: Although the perioperative mortality from hepatic resection has improved considerably, this procedure is still associated with substantial morbidity and resource use. The goal of this investigation was to characterize the incidence, patterns, and risk factors for early reoperation and readmission after hepatectomy. STUDY DESIGN: Perioperative outcomes of 1,281 patients undergoing hepatic resection at an academic center from 1996 to 2009 were analyzed. The indications for early reoperation and readmission (90 days) were reviewed. Multivariate logistic regression analysis was performed to determine variables associated with reoperation and readmission. A scoring system was generated to predict the need for readmission after hepatectomy. RESULTS: Eighty-seven patients (6.8%) required reoperation. The perioperative mortality in patients requiring reoperation was significantly higher than for those not requiring reoperation (23.0% vs 3.4%; p < 0.001). Variables associated with reoperation included male sex, performance of concomitant major nonhepatic procedures, and greater intraoperative blood loss. One hundred and eighty-four patients (14.4%) required readmission. Variables associated with readmission included major hepatectomy, development of major postoperative complications, and index hospitalization >7 days. A Readmission Prediction Score ranging from 0 to 4 was generated and directly correlated with need for readmission. CONCLUSIONS: In the current era of hepatic surgery, early reoperation and readmission remain relatively frequent. As we care for patients who are increasingly receiving regionalized care far from home, we must be mindful of patients at increased risk for readmission. The development of strategies to minimize the complications that necessitate reoperation and readmission is critical to improving patient care.

Duke Scholars

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

May 2013

Volume

216

Issue

5

Start / End Page

915 / 923

Location

United States

Related Subject Headings

  • Surgery
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Reoperation
  • Patient Readmission
  • Multivariate Analysis
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Barbas, A. S., Turley, R. S., Mallipeddi, M. K., Lidsky, M. E., Reddy, S. K., White, R. R., & Clary, B. M. (2013). Examining reoperation and readmission after hepatic surgery. J Am Coll Surg, 216(5), 915–923. https://doi.org/10.1016/j.jamcollsurg.2013.01.008
Barbas, Andrew S., Ryan S. Turley, Mohan K. Mallipeddi, Michael E. Lidsky, Srinevas K. Reddy, Rebekah R. White, and Bryan M. Clary. “Examining reoperation and readmission after hepatic surgery.J Am Coll Surg 216, no. 5 (May 2013): 915–23. https://doi.org/10.1016/j.jamcollsurg.2013.01.008.
Barbas AS, Turley RS, Mallipeddi MK, Lidsky ME, Reddy SK, White RR, et al. Examining reoperation and readmission after hepatic surgery. J Am Coll Surg. 2013 May;216(5):915–23.
Barbas, Andrew S., et al. “Examining reoperation and readmission after hepatic surgery.J Am Coll Surg, vol. 216, no. 5, May 2013, pp. 915–23. Pubmed, doi:10.1016/j.jamcollsurg.2013.01.008.
Barbas AS, Turley RS, Mallipeddi MK, Lidsky ME, Reddy SK, White RR, Clary BM. Examining reoperation and readmission after hepatic surgery. J Am Coll Surg. 2013 May;216(5):915–923.
Journal cover image

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

May 2013

Volume

216

Issue

5

Start / End Page

915 / 923

Location

United States

Related Subject Headings

  • Surgery
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Reoperation
  • Patient Readmission
  • Multivariate Analysis
  • Middle Aged
  • Male