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Hospital readmissions after robotic hepatectomy for neoplastic disease: Analysis of risk factors, survival, and economical impact. A logistical regression and propensity score matched study.
Dugan, Michelle M; Ross, Sharona; Christodoulou, Maria; Pattilachan, Tara M; Flores, Jeilianis Adorno; Rosemurgy, Alexander; Sucandy, Iswanto.
Afiliación
  • Dugan MM; Florida Atlantic University Schmidt College of Medicine, USA; Digestive Health Institute AdventHealth Tampa, USA.
  • Ross S; Digestive Health Institute AdventHealth Tampa, USA.
  • Christodoulou M; Digestive Health Institute AdventHealth Tampa, USA.
  • Pattilachan TM; Digestive Health Institute AdventHealth Tampa, USA.
  • Flores JA; Digestive Health Institute AdventHealth Tampa, USA.
  • Rosemurgy A; Digestive Health Institute AdventHealth Tampa, USA.
  • Sucandy I; Digestive Health Institute AdventHealth Tampa, USA. Electronic address: Iswanto.Sucandy.MD@adventhealth.com.
Am J Surg ; 234: 92-98, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38519401
ABSTRACT

BACKGROUND:

As the first comprehensive investigation into hospital readmissions following robotic hepatectomy for neoplastic disease, this study aims to fill a critical knowledge gap by evaluating risk factors associated with readmission and their impact on survival and the financial burden.

METHODS:

The study analyzed a database of robotic hepatectomy patients, comparing readmitted and non-readmitted individuals post-operatively using 11 propensity score matching. Statistical methods included Chi-square, Mann-Whitney U, T-test, binomial logistic regression, and Kaplan-Meier analysis.

RESULTS:

Among 244 patients, 44 were readmitted within 90 days. Risk factors included hypertension (p â€‹= â€‹0.01), increased Child-Pugh score (p â€‹< â€‹0.01), and R1 margin status (p â€‹= â€‹0.05). Neoadjuvant chemotherapy correlated with lower readmission risk (p â€‹= â€‹0.045). Readmissions didn't significantly impact five-year survival (p â€‹= â€‹0.42) but increased fixed indirect hospital costs (p â€‹< â€‹0.01).

CONCLUSIONS:

Readmission post-robotic hepatectomy correlates with hypertension, higher Child-Pugh scores, and R1 margins. The use of neoadjuvant chemotherapy was associated with a lower admission rate due to less diffuse liver disease in these patients. While not affecting survival, readmissions elevate healthcare costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Puntaje de Propensión / Procedimientos Quirúrgicos Robotizados / Hepatectomía / Neoplasias Hepáticas Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Puntaje de Propensión / Procedimientos Quirúrgicos Robotizados / Hepatectomía / Neoplasias Hepáticas Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos