Readmission After Liver Resection for Intrahepatic Cholangiocarcinoma: a Multi-Institutional Analysis
Gaya Spolverato1, Hadia Maqsood, Alessandro Vitale
1The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
Readmission after liver surgery for intrahepatic cholangiocarcinoma (ICC) affects 1 in 13 patients. Pre-operative jaundice and post-operative complications significantly increase the risk of 30-day readmission.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Intrahepatic cholangiocarcinoma (ICC) is a primary liver cancer.
- Hepatic resection is a key treatment for ICC.
- Understanding readmission rates is crucial for patient outcomes.
Purpose of the Study:
- To determine the incidence of 30-day readmission after hepatic resection for ICC.
- To identify risk factors associated with readmission in ICC patients.
Main Methods:
- Retrospective analysis of 602 patients undergoing hepatic resection for ICC.
- Data collected from 12 international hepatobiliary centers (1990-2013).
- Examined clinicopathologic factors and 30-day readmission rates.
Main Results:
- The 30-day readmission rate was 7.8% (47/602 patients).
- Major hepatectomy was performed in 68.3% of patients.
- Risk factors for readmission included pre-operative jaundice (OR 2.45) and major post-operative complications (OR 3.38).
- 95.7% of readmitted patients had complications versus 38.8% of non-readmitted patients.
Conclusions:
- Readmission after ICC resection occurs in approximately 1 in 13 patients.
- Pre-operative jaundice and post-operative complications are significant predictors of readmission.
- Patients with complications face over a threefold higher risk of readmission.
Background:
The objective of the current study was to define the incidence of 30-day readmission after hepatic resection for intrahepatic cholangiocarcinoma (ICC). In particular, we sought to identify risk factors associated with a higher risk of readmission among patients undergoing resection for ICC.
Methods:
Patients who underwent hepatic resection for ICC at 12 major hepatobiliary centers in the USA, Europe, Australia, and Asia between 1990 and 2013 were identified. Thirty-day readmission and clinicopathologic characteristics associated with higher risk of readmission were examined.
Results:
Among 602 patients, 401 (68.3%) patients underwent a major hepatectomy and 256 (43.3%) experienced at least one post-operative complication. Overall 30-day readmission was 7.8% (n = 47). Risk factors associated with readmission included pre-operative jaundice (odds ratio (OR) 2.45) and the presence of a major complication (OR 3.38). In fact, 95.7% of readmitted patients had experienced a post-operative complication versus only 38.8% of non-readmitted patients (P < 0.001). Among patients who were readmitted, repeat hospitalization was associated with a median LOS of 6.5 days (interquartile range (IQR) 4.0-11.5) and one patient died during readmission.
Conclusions:
Readmission after hepatic resection for ICC occurred in 1 in 13 patients. Patients with pre-operative jaundice and those who experienced a complication had over a threefold higher risk of being readmitted.
