Dugan MM, Ross S, Christodoulou M, Pattilachan TM, Flores JA, Rosemurgy A, Sucandy I. Hospital readmissions after robotic hepatectomy for neoplastic disease: Analysis of risk factors, survival, and economical impact. A logistical regression and propensity score matched study.
Am J Surg 2024;
234:92-98. [PMID:
38519401 DOI:
10.1016/j.amjsurg.2024.03.014]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
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 1:1 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 = 0.01), increased Child-Pugh score (p < 0.01), and R1 margin status (p = 0.05). Neoadjuvant chemotherapy correlated with lower readmission risk (p = 0.045). Readmissions didn't significantly impact five-year survival (p = 0.42) but increased fixed indirect hospital costs (p < 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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