OBJECTIVES: Hospital readmissions after pancreatic resection have been identified as an area of clinical and economic concern. However, most prior studies have focused only on 30-day readmissions and are based on data prior to 2015. This study uses more contemporary data to describe the incidence, indications, and economic burden of 30, 60, and 90-day all-cause readmissions among patients undergoing distal pancreatectomy (DP), pancreaticoduodenectomy (PD), or total pancreatectomy (TP).

METHODS: Data on patients aged ≥18 years undergoing pancreatic resection between October 2015 and March 2019 (first=index admission) were extracted from the Premier Healthcare Database. The primary study outcomes were 30, 60, and 90-day all-cause readmission. The admission type (elective vs. non-elective), primary diagnosis, primary procedure, length of stay (LOS), and total hospital costs of readmissions during these time periods was also collected. All analyses were descriptive in nature.

RESULTS: A total of 3,775 patients underwent DP, 5,510 underwent PD, and 254 underwent TP. Overall, 255 patients (2.5%) died during the index admission. Among those surviving, the readmission rate at 30, 60, and 90 days was 22.4%, 25.8%, and 28.0%. The proportion of readmissions that were non-elective was consistent across time periods, ranging from 91.1%-91.4%. The most common primary diagnoses for readmissions in all three time periods were related to infection/sepsis/peritoneal abscess (35.3%-38.0%). In congruence, the most common primary procedures were for drainage (36.0%-39.0%). The mean (standard deviation, median) LOS and cost of the index admission were 10.8 (10.5, 8.0) days and $38,299 ($37,904, $29,162). In comparison, these values were 7.2 (8.4, 5.0) days and $16,719 ($27,389, $9,407) per readmission over the 90-day follow-up and very similar in magnitude at 30 and 60 days.

CONCLUSIONS: All-cause readmissions are common after major pancreatic resection and continue to accrue beyond the 30-day post-discharge timepoint. Such readmissions tend to be non-elective and are associated with a significant economic burden.