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Surgeon. 2018 Oct;16(5):278-282. doi: 10.1016/j.surge.2018.01.001. Epub 2018 Feb 21.

Hospital readmission rates and risk factors for readmission following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies.

Author information

1
Department of Surgery B, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: yael.dreznik@sheba.health.gov.il.
2
Department of Surgery B, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
3
Division of Clinical Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
4
Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of General and Oncological Surgery-Surgery C, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

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.

KEYWORDS:

CRS/HIPEC; Complications; Readmission

PMID:
29429947
DOI:
10.1016/j.surge.2018.01.001
[Indexed for MEDLINE]

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