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Factors Influencing Readmission After Curative Gastrectomy for Gastric Cancer
*Rima Ahmad1, *Benjamin H Schmidt1, Sam S Yoon2, David W Rattner1, John T Mullen1
1Massachusetts General Hospital, Boston, MA;2Memorial Sloan-Kettering Cancer Center, New York, NY

Objective:To determine the rate and risk factors for 30-day hospital readmission for patients undergoing curative gastrectomy for gastric cancer.
Design:Retrospective case series.
Setting:Tertiary-care cancer center.
Patients:All patients undergoing potentially curative gastrectomy for gastric cancer between 1995 and 2011.
Main Outcome Measures:The 30-day hospital readmission rate and risk factors for readmission.
Results: Thirty-day readmission occurred in 14.6% (61/418) of patients, including 6 patients who were readmitted more than once. The most common reasons for readmission were intraabdominal fluid collections (n =11, 18%), nutritional difficulties (n =10, 16%), and small bowel obstruction (n = 6, 10%). Factors associated with a higher 30-day readmission rate included type of resection (total gastrectomy, 23% vs. subtotal gastrectomy, 13% vs. esophagogastrectomy, 9%, p = 0.016), pre-existing cardiac disease (17%, p = 0.05), major post-operative complications (24%, p < 0.001), and the pathologic findings of venous (23%, p = 0.02) and perineural (20%, p = 0.005) invasion. Factors not associated with higher readmission rates included advanced age, pulmonary comorbidities, T or N stage, extent of lymph node dissection, and length of stay of the initial hospitalization.
Conclusions:Readmission after potentially curative gastrectomy for gastric cancer is common. Patients with pre-existing cardiac disease, those who suffer major post-operative complications, and those undergoing total gastric resections are at especially high risk for readmission, particularly due to nutritional difficulties. Strategies designed to support these high-risk patients upon discharge are warranted.

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Abstract Submission Deadline:
May 5, 2014

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August 13, 2014

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August 11, 2014
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