Harink, S.W.H. (Stian) (2021) Modifiable risk factors accociated with unplanned hospital readmissions after pancreatic surgery. thesis, Medicine.
Full text available on request.Abstract
Introduction: The risk of unplanned hospital readmission (UHR) within 30 days after discharge in patients who underwent pancreatic surgery is high (25-26%). Few risk factors influencing this UHR rate are known. Possible Risk factors for UHR could be related to discharge: i.e. rising C-reactive protein (CRP) blood levels, or discharge at the end of the week. The goal of this study is to gain insight these possible preventable risk factors for UHR after pancreatic surgery. Methods: Patients undergoing pancreatoduodenectomies from 2013 through 2017 or distal pancreatic resections from 2012 through 2020 were included a retrospective cohort study at the University Medial Centre Groningen (UMCG). Data was gathered from DPCA and DICA-registration and Electronic health record of the UMCG and analysed. Results: A total of 241 patients were included whereof 55 (22.8%) had an UHR. In univariate analysis, a significant association was found between UHR and severity of complications (p<.000) and amount of complications(p<.000), CRP at discharge(.043), discharge with drain (p=.046) or enteral nutrition (p=.046). After correction for confounders, in multivariate analysis, complications remained significantly associated with UHR. Thereby, total length of hospital stay was significantly associated with UHR (p=.046). Week or weekend discharge was not significantly associated with UHR. Conclusion: To conclude complications, length of hospital stay and discharge with a drain or discharge with enteral nutrition are significantly associated with UHR in this study. However, unlike hypothesized, rising trend of CRP blood levels or day of discharge were not associated with UHR. Nevertheless, elevation of CRP level at discharge did show a trend of association with UHR, so this could be a lead for future research.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Hogenbirk, drs. R.N.M and Klaase, prof. dr. J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 10:08 |
| Last Modified: | 07 Jan 2022 10:08 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2992 |
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