@article{417ba068b35e411999631fa540f54f54,
title = "Discharge disposition after pancreatic resection for malignancy: Analysis of national trends",
abstract = "Objectives: The aim of this study is to analyse national trends in discharge disposition following pancreatic resection for malignancy in the USA. Methods: The Nationwide Inpatient Sample database was queried for 1993-2005 to identify patients who underwent pancreatic resection for malignancy. The status of patients at discharge (to home, home with home health care or to another facility) was noted. Results: A weighted total of 51 866 patients who underwent pancreatectomy for malignant neoplasm of the pancreas were identified. Patients who died in the postoperative period and patients without a specified discharge disposition were excluded, leaving 43 603 patients for inclusion in the study. Overall mortality improved over the period of the study from 7.1% in 1993 to 5.2% in 2005. The number of patients discharged to another facility increased significantly from 5.5% in 1993 to 13.3% in 2005. Similarly, the number of patients discharged to home with home health assistance increased from 20.0% in 1993 to 33.0% in 2005. This corresponded with a statistically significant decrease in the number of patients discharged to home without assistance, from 74.5% in 1993 to 53.7% in 2005 (P= 0.002). Conclusions: The results of our study demonstrate that following pancreatic resection for malignancy, nearly half the patients will require some assistance after discharge.",
keywords = "age, comorbidities, discharge disposition, factors, malignancy, pancreatic resection",
author = "Shah, {Bhavin C.} and Smith, {Lynette M.} and Fred Ullrich and Chandrakanth Are",
note = "Funding Information: Data drawn from the Nationwide Inpatient Sample (NIS) were utilized to analyse trends in discharge status following pancreatic resection for malignancy. The NIS is a database developed as part of the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (Rockville, MD, USA). The NIS is designed to approximate a 20% sample of US community hospitals. In 2005, NIS data included discharge data from 1054 hospitals located in 37 states. The NIS database was queried for 1993–2005 to identify patients discharged with International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure codes for pancreatectomy [5251 (proximal pancreatectomy), 5252 (distal pancreatectomy), 5253 (radical subtotal pancreatectomy), 5259 (other partial pancreatectomy), 526 (total pancreatectomy), 527 (radical pancreatectomy)] and diagnosis codes for malignant neoplasms of the pancreas [1570 (head of pancreas), 1571 (body of pancreas), 1572 (tail of pancreas), 1573 (pancreatic duct), 1578 (other specified pancreas sites), 1579 (pancreas, part unspecified)]. Patients who underwent pancreatic resection for benign conditions were excluded. Data on patient age, gender, race and income, admission type, hospital size and type, diagnosis, presence of preoperative comorbidities, extent of resection and length of stay were extracted from the database. Preoperative comorbid conditions were identified using the taxonomy published by Elixhauser et al . 12 The status of patients at discharge was noted. {\textquoteleft}Routine{\textquoteright} or {\textquoteleft}home{\textquoteright} discharge was defined as discharge to the patient's home with no health care assistance. {\textquoteleft}Home health care{\textquoteright} discharge was defined as discharge to the patient's home with acknowledged need for the assistance of a visiting nurse or other skilled health care personnel. {\textquoteleft}Other facility{\textquoteright} discharge was defined as discharge or transfer to a skilled nursing, subacute care or nursing facility. For further analysis, {\textquoteleft}Home health care{\textquoteright} and {\textquoteleft}Other facility{\textquoteright} discharge were grouped within the category of {\textquoteleft}Non-routine{\textquoteright} discharge. ",
year = "2012",
month = mar,
doi = "10.1111/j.1477-2574.2011.00427.x",
language = "English (US)",
volume = "14",
pages = "201--208",
journal = "HPB",
issn = "1365-182X",
publisher = "Elsevier B.V.",
number = "3",
}