Readmissions after major cancer surgery among older adults. 

<br/><br/>Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 
<br/><br/> 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.  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.  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.  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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0039-6060 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Abdominal Neoplasms/su [Surgery]<br/>*Patient Readmission/sn [Statistics & Numerical Data]<br/>*Pelvic Neoplasms/su [Surgery]<br/>*Thoracic Neoplasms/su [Surgery]<br/>Age Factors<br/>Aged<br/>Aged, 80 and over<br/>Baltimore<br/>District of Columbia<br/>Female<br/>Humans<br/>Length of Stay/sn [Statistics & Numerical Data]<br/>Length of Stay/td [Trends]<br/>Logistic Models<br/>Male<br/>Multivariate Analysis<br/>Patient Readmission/td [Trends]<br/>Postoperative Complications/th [Therapy]<br/>Retrospective Studies<br/>Risk Factors<br/>Treatment Outcome
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute<br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Surgery/Transplantation