Ahmad et al identified risk factors and reasons for readmission following curative gastrectomy for gastric cancer. These can help to identify a patient who is at increased risk for readmission who may benefit from more aggressive management. The authors are from Massachusetts General Hospital.


Patient selection: curative gastrectomy for gastric cancer


Risk factors for readmission:

(1) total gastrectomy

(2) major complications following surgery (Grade II or higher using the Clavien-Dindo classification)

(3) cardiovascular comorbidity (coronary artery disease, arrhythmia, etc)


Most common reasons for readmission (>= 5% of 61 patients):

(1) nutritional difficulty (unable to meet nutritional needs because of inadequate intake and/or intolerance of feedings)

(2) intra-abdominal fluid collection

(3) small bowel obstruction

(4) anastomotic leak

(5) Clostridium difficile infection

(6) chest pain

(7) pleural effusion


Other reasons occurring less often:

(1) abdominal pain

(2) fever

(3) gastrointestinal hemorrhage

(4) infection at jejunostomy site

(5) pneumonia

(6) anxiety

(7) cardiac arrhythmia

(8) decubitus ulcer

(9) deep vein thrombosis

(10) abnormal electrolytes

(11) infection of PICC line

(12) sepsis

(13) transient ischemic attach

(14) urinary retention


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