Inability to manage non-severe complications on an outpatient basis increases non-white patient readmission rates after pancreaticoduodenectomy: A large metropolitan tertiary care center experience.
Ambulatory Care
/ statistics & numerical data
Female
Healthcare Disparities
/ statistics & numerical data
Hospitals, Urban
/ statistics & numerical data
Humans
Male
Middle Aged
Pancreaticoduodenectomy
/ adverse effects
Patient Readmission
/ statistics & numerical data
Racial Groups
/ statistics & numerical data
Risk Factors
Tertiary Care Centers
/ statistics & numerical data
MAGS
Pancreaticoduodenectomy
Racial disparities
Readmission
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
08
03
2021
revised:
25
03
2021
accepted:
06
04
2021
pubmed:
29
4
2021
medline:
22
12
2021
entrez:
28
4
2021
Statut:
ppublish
Résumé
Pancreaticoduodenectomy (PD) has a high rate of readmission, and racial disparities in care could be an important contributor. Patients undergoing PD were prospectively followed, and their complications graded using the Modified Accordion Grading System (MAGS). Patient factors and perioperative outcomes for patients with and without postoperative readmission were compared in univariate and multivariate analysis by severity. 837 patients underwent PD, the overall 90-day readmission rate was 27.5%. Non-white race was independently associated with readmission (OR 1.83, p = 0.007). 51.3% of readmissions were for non-severe complications (MAGS <3). Non-white race was independently associated with MAGS non-severe readmission (OR 2.13, p = 0.006), but not MAGS severe readmission. Non-white patients are more likely to be readmitted, particularly for non-severe complications. Follow up protocols should be tailored to address race disparities in the rates of readmission as readmission for less severe complications could potentially be avoidable.
Sections du résumé
BACKGROUND
BACKGROUND
Pancreaticoduodenectomy (PD) has a high rate of readmission, and racial disparities in care could be an important contributor.
METHODS
METHODS
Patients undergoing PD were prospectively followed, and their complications graded using the Modified Accordion Grading System (MAGS). Patient factors and perioperative outcomes for patients with and without postoperative readmission were compared in univariate and multivariate analysis by severity.
RESULTS
RESULTS
837 patients underwent PD, the overall 90-day readmission rate was 27.5%. Non-white race was independently associated with readmission (OR 1.83, p = 0.007). 51.3% of readmissions were for non-severe complications (MAGS <3). Non-white race was independently associated with MAGS non-severe readmission (OR 2.13, p = 0.006), but not MAGS severe readmission.
CONCLUSIONS
CONCLUSIONS
Non-white patients are more likely to be readmitted, particularly for non-severe complications. Follow up protocols should be tailored to address race disparities in the rates of readmission as readmission for less severe complications could potentially be avoidable.
Identifiants
pubmed: 33906729
pii: S0002-9610(21)00240-3
doi: 10.1016/j.amjsurg.2021.04.011
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
964-968Informations de copyright
Copyright © 2021. Published by Elsevier Inc.