Risk factors for early readmission after total pancreatectomy and islet auto transplantation
Little published data exist examining causes of hospital readmission following total pancreatectomy with islet autotransplantation (TPIAT). A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital with...
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| Veröffentlicht in: | HPB (Oxford, England) England), 2018-02, Vol.20 (2), p.166-174 |
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| creator | Shahbazov, Rauf Naziruddin, Bashoo Yadav, Kunal Saracino, Giovanna Yoshimatsu, Gumpei Kanak, Mazhar A. Beecherl, Ernest Kim, Peter T. Levy, Marlon F. |
| description | Little published data exist examining causes of hospital readmission following total pancreatectomy with islet autotransplantation (TPIAT).
A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital within 30 days from discharge. Reasons and risk factors for readmission as well as islet function were evaluated and compared by univariate and multivariate analysis.
83 patients underwent TPIAT from 2006 to 2014. 21 patients (25.3%) were readmitted within 30 days. Gastrointestinal problems (52.4%) and surgical site infection (42.8%) were the most common reasons for readmission. Initial LOS and reoperation were risk factors for early readmission. Patients with delayed gastric emptying (DGE) were three times more likely to get readmitted. In multivariate analysis, patients undergoing pylorus preservation surgery were nine times more likely to be readmitted than the antrectomy group.
Early readmission after TPIAT is common (one in four patients), underscoring the complexity of this procedure. Early readmission is not detrimental to islet graft function. Patients undergoing pylorus preservation are more likely to get readmitted, perhaps due to increased incidence of delayed gastric emptying. Decision for antrectomy vs. pylorus preservation needs to be individualized. |
| doi_str_mv | 10.1016/j.hpb.2017.08.033 |
| format | Article |
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A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital within 30 days from discharge. Reasons and risk factors for readmission as well as islet function were evaluated and compared by univariate and multivariate analysis.
83 patients underwent TPIAT from 2006 to 2014. 21 patients (25.3%) were readmitted within 30 days. Gastrointestinal problems (52.4%) and surgical site infection (42.8%) were the most common reasons for readmission. Initial LOS and reoperation were risk factors for early readmission. Patients with delayed gastric emptying (DGE) were three times more likely to get readmitted. In multivariate analysis, patients undergoing pylorus preservation surgery were nine times more likely to be readmitted than the antrectomy group.
Early readmission after TPIAT is common (one in four patients), underscoring the complexity of this procedure. Early readmission is not detrimental to islet graft function. Patients undergoing pylorus preservation are more likely to get readmitted, perhaps due to increased incidence of delayed gastric emptying. Decision for antrectomy vs. pylorus preservation needs to be individualized.</description><identifier>ISSN: 1365-182X</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1016/j.hpb.2017.08.033</identifier><identifier>PMID: 28993044</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Female ; Humans ; Islets of Langerhans Transplantation - adverse effects ; Male ; Middle Aged ; Pancreatectomy - adverse effects ; Patient Readmission ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - therapy ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Transplantation, Autologous - adverse effects ; Treatment Outcome</subject><ispartof>HPB (Oxford, England), 2018-02, Vol.20 (2), p.166-174</ispartof><rights>2017 International Hepato-Pancreato-Biliary Association Inc.</rights><rights>Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-6ace83ce6929b8ff9838bbc9bab84269ce4e0e86ecc80b97f66928b0ead586433</citedby><cites>FETCH-LOGICAL-c396t-6ace83ce6929b8ff9838bbc9bab84269ce4e0e86ecc80b97f66928b0ead586433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28993044$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shahbazov, Rauf</creatorcontrib><creatorcontrib>Naziruddin, Bashoo</creatorcontrib><creatorcontrib>Yadav, Kunal</creatorcontrib><creatorcontrib>Saracino, Giovanna</creatorcontrib><creatorcontrib>Yoshimatsu, Gumpei</creatorcontrib><creatorcontrib>Kanak, Mazhar A.</creatorcontrib><creatorcontrib>Beecherl, Ernest</creatorcontrib><creatorcontrib>Kim, Peter T.</creatorcontrib><creatorcontrib>Levy, Marlon F.</creatorcontrib><title>Risk factors for early readmission after total pancreatectomy and islet auto transplantation</title><title>HPB (Oxford, England)</title><addtitle>HPB (Oxford)</addtitle><description>Little published data exist examining causes of hospital readmission following total pancreatectomy with islet autotransplantation (TPIAT).
A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital within 30 days from discharge. Reasons and risk factors for readmission as well as islet function were evaluated and compared by univariate and multivariate analysis.
83 patients underwent TPIAT from 2006 to 2014. 21 patients (25.3%) were readmitted within 30 days. Gastrointestinal problems (52.4%) and surgical site infection (42.8%) were the most common reasons for readmission. Initial LOS and reoperation were risk factors for early readmission. Patients with delayed gastric emptying (DGE) were three times more likely to get readmitted. In multivariate analysis, patients undergoing pylorus preservation surgery were nine times more likely to be readmitted than the antrectomy group.
Early readmission after TPIAT is common (one in four patients), underscoring the complexity of this procedure. Early readmission is not detrimental to islet graft function. Patients undergoing pylorus preservation are more likely to get readmitted, perhaps due to increased incidence of delayed gastric emptying. Decision for antrectomy vs. pylorus preservation needs to be individualized.</description><subject>Adult</subject><subject>Female</subject><subject>Humans</subject><subject>Islets of Langerhans Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatectomy - adverse effects</subject><subject>Patient Readmission</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - therapy</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Transplantation, Autologous - adverse effects</subject><subject>Treatment Outcome</subject><issn>1365-182X</issn><issn>1477-2574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1LBCEchiWKvv-ALuGxy0w6zjpKp1j6goUgCjoEos5vyG12nNQJ9r_P2K1jJwWf9-X1QeiMkpISyi-X5ftoyorQpiSiJIztoENaN01RzZp6N98ZnxVUVK8H6CjGJSFVjsl9dFAJKRmp60P09uTiB-60TT5E3PmAQYd-jQPoduVidH7AuksQcPJJ93jUg81vCXJgtcZ6aLGLPSSsp-RxCnqIY6-HpFNOnqC9TvcRTrfnMXq5vXme3xeLx7uH-fWisEzyVHBtQTALXFbSiK6TggljrDTaiLri0kINBAQHawUxsul4JoUheeJM8JqxY3Sx6R2D_5wgJpWnW-jzEPBTVFTWkksmxSyjdIPa4GMM0KkxuJUOa0WJ-pGqlipLVT9SFREqS82Z8239ZFbQ_iV-LWbgagNA_uSXg6CidTBYaF3IolTr3T_131lQifE</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Shahbazov, Rauf</creator><creator>Naziruddin, Bashoo</creator><creator>Yadav, Kunal</creator><creator>Saracino, Giovanna</creator><creator>Yoshimatsu, Gumpei</creator><creator>Kanak, Mazhar A.</creator><creator>Beecherl, Ernest</creator><creator>Kim, Peter T.</creator><creator>Levy, Marlon F.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201802</creationdate><title>Risk factors for early readmission after total pancreatectomy and islet auto transplantation</title><author>Shahbazov, Rauf ; 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A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital within 30 days from discharge. Reasons and risk factors for readmission as well as islet function were evaluated and compared by univariate and multivariate analysis.
83 patients underwent TPIAT from 2006 to 2014. 21 patients (25.3%) were readmitted within 30 days. Gastrointestinal problems (52.4%) and surgical site infection (42.8%) were the most common reasons for readmission. Initial LOS and reoperation were risk factors for early readmission. Patients with delayed gastric emptying (DGE) were three times more likely to get readmitted. In multivariate analysis, patients undergoing pylorus preservation surgery were nine times more likely to be readmitted than the antrectomy group.
Early readmission after TPIAT is common (one in four patients), underscoring the complexity of this procedure. Early readmission is not detrimental to islet graft function. Patients undergoing pylorus preservation are more likely to get readmitted, perhaps due to increased incidence of delayed gastric emptying. Decision for antrectomy vs. pylorus preservation needs to be individualized.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28993044</pmid><doi>10.1016/j.hpb.2017.08.033</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Female Humans Islets of Langerhans Transplantation - adverse effects Male Middle Aged Pancreatectomy - adverse effects Patient Readmission Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - therapy Retrospective Studies Risk Assessment Risk Factors Time Factors Transplantation, Autologous - adverse effects Treatment Outcome |
| title | Risk factors for early readmission after total pancreatectomy and islet auto transplantation |
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