Treatment outcomes, 30-day readmission and healthcare resource utilization after pancreatoduodenectomy for pancreatic malignancies

Heather Peluso, Wesley B. Jones, Alexander A. Parikh, Marwan S. Abougergi

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background: We sought to determine treatment outcomes after pancreatoduodenectomy for pancreatic head and uncinate process malignancy and its impact on mortality, morbidity, and resource utilization. Methods: This was a retrospective cohort study using the 2014 Nationwide Readmissions Database. Discharges were included if they had an ICD-9 CM procedure code for pancreatoduodenectomy and any code for malignancy of the pancreas head and uncinate process. Independent predictors of readmission were identified using multivariable Cox regression analysis. Results: A total of 4,445 patients were included. The surgical complication rate was 17.3%, and in-hospital mortality rate was 3%. The 30-day readmission rate was 19.7% with an in-hospital mortality rate of 3.9%. The most common reason for readmission was postoperative infection. The mean length of stay during readmission was 6.50 days, while the mean total hospitalization costs and charges were $15,589 and $52,922, respectively. The number of hospital days associated with readmission was 5,548, with an in-hospital economic burden of $12.9 million (costs) and $43.7 million (charges). Hospital volume and discharge disposition were independent predictors of 30-day readmission. Conclusions: Pancreatoduodenectomy for pancreatic malignancies is still associated with significant morbidity, mortality and 30-day readmission. Reducing readmission can impact mortality, quality of life, and healthcare economic burden in this setting.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume26
Issue number5
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • Economic burden
  • Mortality
  • Readmission
  • Resource utilization
  • Whipple procedure

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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