Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma

Javier Valero-Elizondo, Yuhree Kim, Jason D. Prescott, Georgios A. Margonis, Thuy B. Tran, Lauren M. Postlewait, Shishir K. Maithel, Tracy S. Wang, Jason A. Glenn, Ioannis Hatzaras, Rivfka Shenoy, John E. Phay, Kara Keplinger, Ryan C. Fields, Linda X. Jin, Sharon M. Weber, Ahmed Salem, Jason K. Sicklick, Shady Gad, Adam C. YoppJohn C. Mansour, Quan Yang Duh, Natalie Seiser, Carmen C. Solorzano, Colleen M. Kiernan, Konstantinos I. Votanopoulos, Edward A. Levine, George A. Poultsides, Timothy M. Pawlik

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. Given the lack of data on readmission after resection of ACC, the objective of the current study was to define the incidence of readmission, as well as identify risk factors associated with readmission among patients with ACC who underwent surgical resection. Methods: Two hundred nine patients who underwent resection of ACC between January 1993 and December 2014 at 1 of 13 major centers in the USA were identified. Demographic and clinicopathological data were collected and analyzed relative to readmission. Results: Median patient age was 52 years, and 62 % of the patients were female. Median tumor size was 12 cm, and the majority of patients had an American Society of Anesthesiologists (ASA) class of 3–4 (n = 85, 56 %). The overall incidence of readmission within 90 days from surgery was 18 % (n = 38). Factors associated with readmission included high ASA class (odds ratio (OR), 4.88 (95 % confidence interval (CI), 1.75–13.61); P = 0.002), metastatic disease on presentation (OR, 2.98 (95 % CI, 1.37–6.46); P = 0.006), EBL (>700 mL: OR, 2.75 (95 % CI, 1.16–6.51); P = 0.02), complication (OR, 1.91 (95 % CI, 1.20–3.05); P = 0.007), and prolonged length of stay (LOS; ≥9 days: OR, 4.12 (95 % CI, 1.88–9.01); P <0.001). On multivariate logistic regression, a high ASA class (OR, 4.01 (95 % CI, 1.44–11.17); P = 0.008) and metastatic disease on presentation (OR, 3.44 (95 % CI, 1.34–8.84); P = 0.01) remained independently associated with higher odds of readmission. Conclusion: Readmission following surgery for ACC was common as one in five patients experienced a readmission. Patients with a high ASA class and metastatic disease on presentation were over four and three times more likely to be readmitted after surgical treatment for ACC, respectively.

Original languageEnglish (US)
Pages (from-to)2154-2161
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number12
DOIs
StatePublished - Dec 1 2015

Fingerprint

Adrenocortical Carcinoma
Odds Ratio
Confidence Intervals
Incidence
Therapeutics
Patient Readmission
Rare Diseases
Length of Stay
Logistic Models
Demography

Keywords

  • Adrenocortical carcinoma
  • Readmission
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Valero-Elizondo, J., Kim, Y., Prescott, J. D., Margonis, G. A., Tran, T. B., Postlewait, L. M., ... Pawlik, T. M. (2015). Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma. Journal of Gastrointestinal Surgery, 19(12), 2154-2161. https://doi.org/10.1007/s11605-015-2917-x

Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma. / Valero-Elizondo, Javier; Kim, Yuhree; Prescott, Jason D.; Margonis, Georgios A.; Tran, Thuy B.; Postlewait, Lauren M.; Maithel, Shishir K.; Wang, Tracy S.; Glenn, Jason A.; Hatzaras, Ioannis; Shenoy, Rivfka; Phay, John E.; Keplinger, Kara; Fields, Ryan C.; Jin, Linda X.; Weber, Sharon M.; Salem, Ahmed; Sicklick, Jason K.; Gad, Shady; Yopp, Adam C.; Mansour, John C.; Duh, Quan Yang; Seiser, Natalie; Solorzano, Carmen C.; Kiernan, Colleen M.; Votanopoulos, Konstantinos I.; Levine, Edward A.; Poultsides, George A.; Pawlik, Timothy M.

In: Journal of Gastrointestinal Surgery, Vol. 19, No. 12, 01.12.2015, p. 2154-2161.

Research output: Contribution to journalArticle

Valero-Elizondo, J, Kim, Y, Prescott, JD, Margonis, GA, Tran, TB, Postlewait, LM, Maithel, SK, Wang, TS, Glenn, JA, Hatzaras, I, Shenoy, R, Phay, JE, Keplinger, K, Fields, RC, Jin, LX, Weber, SM, Salem, A, Sicklick, JK, Gad, S, Yopp, AC, Mansour, JC, Duh, QY, Seiser, N, Solorzano, CC, Kiernan, CM, Votanopoulos, KI, Levine, EA, Poultsides, GA & Pawlik, TM 2015, 'Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma', Journal of Gastrointestinal Surgery, vol. 19, no. 12, pp. 2154-2161. https://doi.org/10.1007/s11605-015-2917-x
Valero-Elizondo, Javier ; Kim, Yuhree ; Prescott, Jason D. ; Margonis, Georgios A. ; Tran, Thuy B. ; Postlewait, Lauren M. ; Maithel, Shishir K. ; Wang, Tracy S. ; Glenn, Jason A. ; Hatzaras, Ioannis ; Shenoy, Rivfka ; Phay, John E. ; Keplinger, Kara ; Fields, Ryan C. ; Jin, Linda X. ; Weber, Sharon M. ; Salem, Ahmed ; Sicklick, Jason K. ; Gad, Shady ; Yopp, Adam C. ; Mansour, John C. ; Duh, Quan Yang ; Seiser, Natalie ; Solorzano, Carmen C. ; Kiernan, Colleen M. ; Votanopoulos, Konstantinos I. ; Levine, Edward A. ; Poultsides, George A. ; Pawlik, Timothy M. / Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma. In: Journal of Gastrointestinal Surgery. 2015 ; Vol. 19, No. 12. pp. 2154-2161.
@article{fed7eef6dbb1468c90ab335c19a45614,
title = "Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma",
abstract = "Background: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. Given the lack of data on readmission after resection of ACC, the objective of the current study was to define the incidence of readmission, as well as identify risk factors associated with readmission among patients with ACC who underwent surgical resection. Methods: Two hundred nine patients who underwent resection of ACC between January 1993 and December 2014 at 1 of 13 major centers in the USA were identified. Demographic and clinicopathological data were collected and analyzed relative to readmission. Results: Median patient age was 52 years, and 62 {\%} of the patients were female. Median tumor size was 12 cm, and the majority of patients had an American Society of Anesthesiologists (ASA) class of 3–4 (n = 85, 56 {\%}). The overall incidence of readmission within 90 days from surgery was 18 {\%} (n = 38). Factors associated with readmission included high ASA class (odds ratio (OR), 4.88 (95 {\%} confidence interval (CI), 1.75–13.61); P = 0.002), metastatic disease on presentation (OR, 2.98 (95 {\%} CI, 1.37–6.46); P = 0.006), EBL (>700 mL: OR, 2.75 (95 {\%} CI, 1.16–6.51); P = 0.02), complication (OR, 1.91 (95 {\%} CI, 1.20–3.05); P = 0.007), and prolonged length of stay (LOS; ≥9 days: OR, 4.12 (95 {\%} CI, 1.88–9.01); P <0.001). On multivariate logistic regression, a high ASA class (OR, 4.01 (95 {\%} CI, 1.44–11.17); P = 0.008) and metastatic disease on presentation (OR, 3.44 (95 {\%} CI, 1.34–8.84); P = 0.01) remained independently associated with higher odds of readmission. Conclusion: Readmission following surgery for ACC was common as one in five patients experienced a readmission. Patients with a high ASA class and metastatic disease on presentation were over four and three times more likely to be readmitted after surgical treatment for ACC, respectively.",
keywords = "Adrenocortical carcinoma, Readmission, Surgery",
author = "Javier Valero-Elizondo and Yuhree Kim and Prescott, {Jason D.} and Margonis, {Georgios A.} and Tran, {Thuy B.} and Postlewait, {Lauren M.} and Maithel, {Shishir K.} and Wang, {Tracy S.} and Glenn, {Jason A.} and Ioannis Hatzaras and Rivfka Shenoy and Phay, {John E.} and Kara Keplinger and Fields, {Ryan C.} and Jin, {Linda X.} and Weber, {Sharon M.} and Ahmed Salem and Sicklick, {Jason K.} and Shady Gad and Yopp, {Adam C.} and Mansour, {John C.} and Duh, {Quan Yang} and Natalie Seiser and Solorzano, {Carmen C.} and Kiernan, {Colleen M.} and Votanopoulos, {Konstantinos I.} and Levine, {Edward A.} and Poultsides, {George A.} and Pawlik, {Timothy M.}",
year = "2015",
month = "12",
day = "1",
doi = "10.1007/s11605-015-2917-x",
language = "English (US)",
volume = "19",
pages = "2154--2161",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "12",

}

TY - JOUR

T1 - Incidence and Risk Factors Associated with Readmission After Surgical Treatment for Adrenocortical Carcinoma

AU - Valero-Elizondo, Javier

AU - Kim, Yuhree

AU - Prescott, Jason D.

AU - Margonis, Georgios A.

AU - Tran, Thuy B.

AU - Postlewait, Lauren M.

AU - Maithel, Shishir K.

AU - Wang, Tracy S.

AU - Glenn, Jason A.

AU - Hatzaras, Ioannis

AU - Shenoy, Rivfka

AU - Phay, John E.

AU - Keplinger, Kara

AU - Fields, Ryan C.

AU - Jin, Linda X.

AU - Weber, Sharon M.

AU - Salem, Ahmed

AU - Sicklick, Jason K.

AU - Gad, Shady

AU - Yopp, Adam C.

AU - Mansour, John C.

AU - Duh, Quan Yang

AU - Seiser, Natalie

AU - Solorzano, Carmen C.

AU - Kiernan, Colleen M.

AU - Votanopoulos, Konstantinos I.

AU - Levine, Edward A.

AU - Poultsides, George A.

AU - Pawlik, Timothy M.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. Given the lack of data on readmission after resection of ACC, the objective of the current study was to define the incidence of readmission, as well as identify risk factors associated with readmission among patients with ACC who underwent surgical resection. Methods: Two hundred nine patients who underwent resection of ACC between January 1993 and December 2014 at 1 of 13 major centers in the USA were identified. Demographic and clinicopathological data were collected and analyzed relative to readmission. Results: Median patient age was 52 years, and 62 % of the patients were female. Median tumor size was 12 cm, and the majority of patients had an American Society of Anesthesiologists (ASA) class of 3–4 (n = 85, 56 %). The overall incidence of readmission within 90 days from surgery was 18 % (n = 38). Factors associated with readmission included high ASA class (odds ratio (OR), 4.88 (95 % confidence interval (CI), 1.75–13.61); P = 0.002), metastatic disease on presentation (OR, 2.98 (95 % CI, 1.37–6.46); P = 0.006), EBL (>700 mL: OR, 2.75 (95 % CI, 1.16–6.51); P = 0.02), complication (OR, 1.91 (95 % CI, 1.20–3.05); P = 0.007), and prolonged length of stay (LOS; ≥9 days: OR, 4.12 (95 % CI, 1.88–9.01); P <0.001). On multivariate logistic regression, a high ASA class (OR, 4.01 (95 % CI, 1.44–11.17); P = 0.008) and metastatic disease on presentation (OR, 3.44 (95 % CI, 1.34–8.84); P = 0.01) remained independently associated with higher odds of readmission. Conclusion: Readmission following surgery for ACC was common as one in five patients experienced a readmission. Patients with a high ASA class and metastatic disease on presentation were over four and three times more likely to be readmitted after surgical treatment for ACC, respectively.

AB - Background: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. Given the lack of data on readmission after resection of ACC, the objective of the current study was to define the incidence of readmission, as well as identify risk factors associated with readmission among patients with ACC who underwent surgical resection. Methods: Two hundred nine patients who underwent resection of ACC between January 1993 and December 2014 at 1 of 13 major centers in the USA were identified. Demographic and clinicopathological data were collected and analyzed relative to readmission. Results: Median patient age was 52 years, and 62 % of the patients were female. Median tumor size was 12 cm, and the majority of patients had an American Society of Anesthesiologists (ASA) class of 3–4 (n = 85, 56 %). The overall incidence of readmission within 90 days from surgery was 18 % (n = 38). Factors associated with readmission included high ASA class (odds ratio (OR), 4.88 (95 % confidence interval (CI), 1.75–13.61); P = 0.002), metastatic disease on presentation (OR, 2.98 (95 % CI, 1.37–6.46); P = 0.006), EBL (>700 mL: OR, 2.75 (95 % CI, 1.16–6.51); P = 0.02), complication (OR, 1.91 (95 % CI, 1.20–3.05); P = 0.007), and prolonged length of stay (LOS; ≥9 days: OR, 4.12 (95 % CI, 1.88–9.01); P <0.001). On multivariate logistic regression, a high ASA class (OR, 4.01 (95 % CI, 1.44–11.17); P = 0.008) and metastatic disease on presentation (OR, 3.44 (95 % CI, 1.34–8.84); P = 0.01) remained independently associated with higher odds of readmission. Conclusion: Readmission following surgery for ACC was common as one in five patients experienced a readmission. Patients with a high ASA class and metastatic disease on presentation were over four and three times more likely to be readmitted after surgical treatment for ACC, respectively.

KW - Adrenocortical carcinoma

KW - Readmission

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=84947028776&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947028776&partnerID=8YFLogxK

U2 - 10.1007/s11605-015-2917-x

DO - 10.1007/s11605-015-2917-x

M3 - Article

C2 - 26286367

AN - SCOPUS:84947028776

VL - 19

SP - 2154

EP - 2161

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 12

ER -