MedStar Authors catalog › Details for: Readmissions after major cancer surgery among older adults.
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Readmissions after major cancer surgery among older adults.

by Huang, Chun Chih; Colton, Scott; Potosky, Arnold L; Johnson, Lynt B; Shara, Nawar M; Al-Refaie, Waddah B.
Citation: Surgery. 158(2):428-37, 2015 Aug..ISSN: 0039-6060.Full author list: Langan RC; Huang CC; Colton S; Potosky AL; Johnson LB; Shara NM; Al-Refaie WB.UI/PMID: 26003911.Subject(s): *Abdominal Neoplasms/su [Surgery] | Age Factors | Aged | Aged, 80 and over | Baltimore | District of Columbia | Female | Humans | Length of Stay/sn [Statistics & Numerical Data] | Length of Stay/td [Trends] | Logistic Models | Male | Multivariate Analysis | *Patient Readmission/sn [Statistics & Numerical Data] | Patient Readmission/td [Trends] | *Pelvic Neoplasms/su [Surgery] | Postoperative Complications/th [Therapy] | Retrospective Studies | Risk Factors | *Thoracic Neoplasms/su [Surgery] | Treatment OutcomeInstitution(s): MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment(s): Surgery/TransplantationActivity type: Journal Article.Online resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.surg.2015.01.028 (Click here) Abbreviated citation: Surgery. 158(2):428-37, 2015 Aug.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: BACKGROUND: Decreasing readmissions has become a focus of emerging efforts to improve the quality and affordability of health care. However, little is known about reasons for readmissions after major cancer surgery in the expanding elderly population (>65 years) who are also at increased risk of adverse operative events. We sought to identify (1) the extent to which older age impacts readmissions and (2) factors predictive of 30- and 90-day readmissions after major cancer surgery among older adults.Abstract: METHODS: We identified 2,797 older adults who underwent 1 of 7 types of major thoracic or abdominopelvic cancer surgery within a large multihospital system from 2003 to 2012. Multivariate logistic regression analyses were conducted to identify predictors of 30- and 90-day readmission controlling for covariates.Abstract: RESULTS: Overall 30- and 90-day readmission rates were 16% and 24% with the majority of readmissions occurring within 15-days of discharge. Principal diagnoses of 30-day readmissions included gastrointestinal, pulmonary, and infections complications. The 30-day readmissions were associated with >2 comorbid conditions and >2 postoperative complications. Readmissions varied significantly according to cancer surgery type and across treating hospitals. Readmissions did not vary by increasing age. Factors associated with 90-day readmission were comparable to those observed at 30 days.Abstract: CONCLUSION: In this large, multihospital study of older adults, multiple morbidities, procedure type, greater number of complications, and the treating hospital predicted 30- and 90-day readmissions. These findings point toward the potential impact of hospital-level factors behind readmission. Our results also heighten the importance of assessing the influence of readmission on other important cancer care metrics, namely, patient-reported outcomes and the completion of adjuvant systemic therapies.Copyright � 2015 Elsevier Inc. All rights reserved.

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