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

  • Raito Asaoka
  • Taiichi Kawamura
  • Rie Makuuchi
  • Tomoyuki Irino
  • Yutaka Tanizawa
  • Etsuro Bando
  • Masanori Terashima
Original Article

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

Hospital readmission Radical gastrectomy Gastric cancer 

Notes

Acknowledgements

This work was supported in part by The National Cancer Center Research and Development Fund (29-A-3).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. The ethics committees of SCC (Shizuoka, Japan) reviewed and approved this study (no. 29-J158-29-1-3).

Informed consent

Informed consent or a substitute for it was obtained from all patients before being included in the study.

Supplementary material

10120_2018_856_MOESM1_ESM.tif (714 kb)
A box plot and violin plot of the CRP values on POD3 (TIF 713 KB)
10120_2018_856_MOESM2_ESM.tif (2 mb)
The comparison of the longitudinal changes in the CRP values according to the reasons for readmission (TIF 2034 KB)
10120_2018_856_MOESM3_ESM.docx (16 kb)
Supplementary material 3 (DOCX 15 KB)

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  1. 1.Division of Gastric SurgeryShizuoka Cancer CenterShizuokaJapan

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