1. Hospital readmission rates and risk factors for readmission following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies
- Author
-
Yaniv Berger, Yossi Dux, Harel Jacoby, Tamar Hamburger, Yael Dreznik, Almog Ben-Yaacov, Mordechai Gutman, Aviad Hoffman, and Aviram Nissan
- Subjects
Male ,medicine.medical_specialty ,Peritoneal surface ,medicine.medical_treatment ,Patient Readmission ,Risk Assessment ,03 medical and health sciences ,High morbidity ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Intestinal Neoplasms ,Humans ,Medicine ,Peritoneal Neoplasms ,Retrospective Studies ,Chemotherapy ,Hospital readmission ,business.industry ,Cytoreduction Surgical Procedures ,Hyperthermia, Induced ,Middle Aged ,medicine.disease ,Bowel obstruction ,Abdominal Neoplasms ,030220 oncology & carcinogenesis ,Conventional PCI ,Female ,030211 gastroenterology & hepatology ,Surgery ,Hyperthermic intraperitoneal chemotherapy ,business ,Cytoreductive surgery - Abstract
Background Cytoreductive surgery and Hyperthermic intra-peritoneal chemotherapy (CRS/HIPEC) for peritoneal surface malignancies is associated with high morbidity. The increased numbers of patients undergoing CRS/HIPEC in recent years mandates risk analysis and quality assurance. However, only scarce data exist regarding causative parameters for readmission. The aim of this study was to assess readmission rates and risk factors associated with readmission. Methods A retrospective-cohort study including patients from two high-volume centers who underwent CRS/HIPEC surgery between the years 2007–2016 was performed. Patients' demographics, peri-operative data and readmission rates were recorded. Results 223 patients were included in the study. The 7 and 30-day readmission rates were 3.5% (n = 8) and 11% (n = 25), respectively. Late readmission rates (up to 90 days) were 11% (n = 25). The most common causes of readmission were surgical related infections (35%), small bowel obstruction (17.5%) and dehydration (14%). Post-operative complications were associated with higher readmission rates (p = 0.0001). PCI score was not associated with higher rates of readmission. Conclusion Readmissions following CRS/HIPEC occur mainly due to infectious complications and dehydrations. Patients following CRS/HIPEC should be discharged after careful investigation to a community based continuing care with access for IV fluid replacement or antibiotics administration when required.
- Published
- 2018
- Full Text
- View/download PDF