Factors associated with 30-day readmission and long-term efficacy of enteral stent placement for malignancy |
| |
Authors: | Udayakumar Navaneethan Sudhir Duvuru Ramprasad Jegadeesan Preethi G K Venkatesh Norma G Gutierrez Jeffrey Hammel Ravi P Kiran Madhusudhan R Sanaka |
| |
Institution: | 1. Department of Gastroenterology, Digestive Disease Institute, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA 2. Department of Colorectal Surgery, Digestive Disease Institute, The Cleveland Clinic Foundation, Cleveland, OH, USA
|
| |
Abstract: | Background Readmissions to the hospital within 30 days of discharge (30-day readmission rate) may impact stent use in palliative treatment of cancer. Objective Our objective was to investigate the incidence of readmission and factors predicting readmissions and long-term outcomes in patients with self-expanding metal stents (SEMS) placed for malignant obstruction. Methods Retrospective analysis of all patients who underwent placement of SEMS from 2007 to 2012 for malignant esophageal, gastroduodenal, and colonic obstruction. Incidence and variables associated with 30-day readmission and long-term outcomes were determined. Results A total of 191 patients underwent stent placement. The 30-day readmission rate was 17.3 % (N = 33). Readmissions were for stent-related complications in 7.3 % (N = 14) and non-stent-related complications in 9.9 % (N = 19). Stent placement was technically successful in 185 of 191 (96.9 %) and clinically successful in 170 of 191 (89.0 %) patients. On long-term follow-up, 32 (16.8 %) patients needed re-intervention. The mean stent patency was 142 days. Readmission within 30 days was independently associated with development of early complications (<7 days) following stent placement (odds ratio OR] 5.90; 95 % confidence interval CI] 2.04–17.1), while the stent location did not impact readmission risk. On Cox regression analysis, American Society of Anesthesiologists physical classification (OR 1.36; 95 % CI 1.02–1.87) and stent location in the esophagus (OR 1.82; 95 % CI 1.10–3.02) were independently associated with long-term mortality. Conclusions Early complications following stent placement increase the risk of 30-day readmission. SEMS is efficacious long-term for palliation of malignant gastrointestinal obstruction. |
| |
Keywords: | |
本文献已被 SpringerLink 等数据库收录! |
|