Risk factors for 30-day hospital readmission after radical gastrectomy: a single-center retrospective study

Gastric Cancer. 2019 Mar;22(2):413-420. doi: 10.1007/s10120-018-0856-4. Epub 2018 Jul 13.

Abstract

Background: Hospital readmission is gathering greater attention as a measure of health care quality. The introduction of fast-track surgery has led to shorter lengths of hospitalization without increasing the risk of postoperative complications and readmission. The collection of comprehensive readmission data is essential for the further improvement of patient care. The aim of the present study is to evaluate the risk factors for readmission within 30 days of discharge after gastrectomy.

Methods: A total of 1929 patients who underwent radical gastrectomy at Shizuoka Cancer Center were included in this study. A risk analysis with a stepwise logistic regression model was conducted to identify the risk factors for 30-day hospital readmission.

Results: The 30-day readmission rate was 2.70%. Common causes of readmission were an intolerance of oral intake and the presence of an intra-abdominal abscess. The C reactive protein (CRP) level on postoperative day (POD) 3 was significantly higher in the readmitted group; however, the other surgical outcomes, including the incidence of postoperative complications, did not differ to a statistically significant extent. The stepwise logistic regression analysis revealed that CRP on POD3 ≥ 12 mg/dl [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.09-3.95, p = 0.025], laparoscopic surgery (OR 2.25, 95% CI 1.17-4.31, p = 0.015), and TG (OR 2.23, 95% CI 1.17-4.78, p = 0.023) were found to be independent risk factors for readmission.

Conclusions: CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.

Keywords: Gastric cancer; Hospital readmission; Radical gastrectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / analysis*
  • Female
  • Gastrectomy / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / surgery*
  • Young Adult

Substances

  • C-Reactive Protein