TY - JOUR
T1 - Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma
AU - Valero-Elizondo, Javier
AU - Kim, Yuhree
AU - Prescott, Jason D.
AU - Margonis, Georgios A.
AU - Tran, Thuy B.
AU - Postlewait, Lauren M.
AU - Maithel, Shishir K.
AU - Wang, Tracy S.
AU - Glenn, Jason A.
AU - Hatzaras, Ioannis
AU - Shenoy, Rivfka
AU - Phay, John E.
AU - Keplinger, Kara
AU - Fields, Ryan C.
AU - Jin, Linda X.
AU - Weber, Sharon M.
AU - Salem, Ahmed
AU - Sicklick, Jason K.
AU - Gad, Shady
AU - Yopp, Adam C.
AU - Mansour, John C.
AU - Duh, Quan Yang
AU - Seiser, Natalie
AU - Solorzano, Carmen C.
AU - Kiernan, Colleen M.
AU - Votanopoulos, Konstantinos I.
AU - Levine, Edward A.
AU - Poultsides, George A.
AU - Pawlik, Timothy M.
N1 - Publisher Copyright:
© 2015, The Society for Surgery of the Alimentary Tract.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. Given the lack of data on readmission after resection of ACC, the objective of the current study was to define the incidence of readmission, as well as identify risk factors associated with readmission among patients with ACC who underwent surgical resection. Methods: Two hundred nine patients who underwent resection of ACC between January 1993 and December 2014 at 1 of 13 major centers in the USA were identified. Demographic and clinicopathological data were collected and analyzed relative to readmission. Results: Median patient age was 52 years, and 62 % of the patients were female. Median tumor size was 12 cm, and the majority of patients had an American Society of Anesthesiologists (ASA) class of 3–4 (n = 85, 56 %). The overall incidence of readmission within 90 days from surgery was 18 % (n = 38). Factors associated with readmission included high ASA class (odds ratio (OR), 4.88 (95 % confidence interval (CI), 1.75–13.61); P = 0.002), metastatic disease on presentation (OR, 2.98 (95 % CI, 1.37–6.46); P = 0.006), EBL (>700 mL: OR, 2.75 (95 % CI, 1.16–6.51); P = 0.02), complication (OR, 1.91 (95 % CI, 1.20–3.05); P = 0.007), and prolonged length of stay (LOS; ≥9 days: OR, 4.12 (95 % CI, 1.88–9.01); P < 0.001). On multivariate logistic regression, a high ASA class (OR, 4.01 (95 % CI, 1.44–11.17); P = 0.008) and metastatic disease on presentation (OR, 3.44 (95 % CI, 1.34–8.84); P = 0.01) remained independently associated with higher odds of readmission. Conclusion: Readmission following surgery for ACC was common as one in five patients experienced a readmission. Patients with a high ASA class and metastatic disease on presentation were over four and three times more likely to be readmitted after surgical treatment for ACC, respectively.
AB - Background: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. Given the lack of data on readmission after resection of ACC, the objective of the current study was to define the incidence of readmission, as well as identify risk factors associated with readmission among patients with ACC who underwent surgical resection. Methods: Two hundred nine patients who underwent resection of ACC between January 1993 and December 2014 at 1 of 13 major centers in the USA were identified. Demographic and clinicopathological data were collected and analyzed relative to readmission. Results: Median patient age was 52 years, and 62 % of the patients were female. Median tumor size was 12 cm, and the majority of patients had an American Society of Anesthesiologists (ASA) class of 3–4 (n = 85, 56 %). The overall incidence of readmission within 90 days from surgery was 18 % (n = 38). Factors associated with readmission included high ASA class (odds ratio (OR), 4.88 (95 % confidence interval (CI), 1.75–13.61); P = 0.002), metastatic disease on presentation (OR, 2.98 (95 % CI, 1.37–6.46); P = 0.006), EBL (>700 mL: OR, 2.75 (95 % CI, 1.16–6.51); P = 0.02), complication (OR, 1.91 (95 % CI, 1.20–3.05); P = 0.007), and prolonged length of stay (LOS; ≥9 days: OR, 4.12 (95 % CI, 1.88–9.01); P < 0.001). On multivariate logistic regression, a high ASA class (OR, 4.01 (95 % CI, 1.44–11.17); P = 0.008) and metastatic disease on presentation (OR, 3.44 (95 % CI, 1.34–8.84); P = 0.01) remained independently associated with higher odds of readmission. Conclusion: Readmission following surgery for ACC was common as one in five patients experienced a readmission. Patients with a high ASA class and metastatic disease on presentation were over four and three times more likely to be readmitted after surgical treatment for ACC, respectively.
KW - Adrenocortical carcinoma
KW - Readmission
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84947028776&partnerID=8YFLogxK
U2 - 10.1007/s11605-015-2917-x
DO - 10.1007/s11605-015-2917-x
M3 - Article
C2 - 26286367
AN - SCOPUS:84947028776
SN - 1091-255X
VL - 19
SP - 2154
EP - 2161
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 12
ER -