Risk Factors Hospital Readmission Score Following Major Hepatectomy

Description

Egger et al developed a score for predicting risk of readmission following major hepatectomy. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Louisville, Emory University, and the University of Wisconsin.

Patient selection: status post major hepatectomy

Parameters:

(1) estimated blood loss in mL

(2) postoperative red blood cell transfusion

(3) complications

(4) maximum postoperative total serum bilirubin in mg/dL

(5) surgical site infection (wound and/or intra-abdominal)

(6) postoperative pulmonary embolism

Parameters	Findings	Points
estimated blood loss	< 500 mL	0
	500 to 1,000 mL	3
	> 1,000 mL	6
postoperative blood transfusion	no	12
	yes	0
complications	none	0
	minor (Clavien-Dindo Class 1 or 2)	15
	major (Clavien-Dindog Class 3 or higher)	33
maximum peak total serum bilirubin	< 2.0 mg/dL	0
	2.0 to 2.9 mg/dL	2
	3.0 to 3.9 mg/dL	3
	4.0 to 4.9 mg/dL	5
	5.0 to 5.9 mg/dL	6
	>= 6.0 mg/dL	7
surgical site infection	no	0
	yes	17
postoperative pulmonary embolism	no	0
	yes	26

where:

• Surgical site infection and pulmonary embolism are not scored as complications in the implementation.

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 101

• The higher the score the greater the risk for readmission.

Score	Risk Group	Readmission Rate
<= 20	low	4.4%
21 to 50	intermediate	24%
>= 51	high	51%

Performance:

• The area under the ROC curve is 0.81.

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Description

Specialty

Objective

ICD-10

Score for Readmission Following Major Hepatectomy

Purpose: To identify the risk for readmission following a major hepatectomy using the score of Egger et al.

Description

Specialty

Objective

ICD-10