This paper was presented at the International Hepato-Pancreato-Biliary Association Meeting, 18–22 April 2010, Buenos Aires, Argentina.
National trends in discharge disposition after hepatic resection for malignancy
Article first published online: 17 JAN 2011
© 2011 International Hepato-Pancreato-Biliary Association
Volume 13, Issue 2, pages 96–102, February 2011
How to Cite
Shah, B. C., Ullrich, F., Smith, L., Leiphrakpam, P., Ly, Q., Sasson, A. and Are, C. (2011), National trends in discharge disposition after hepatic resection for malignancy. HPB, 13: 96–102. doi: 10.1111/j.1477-2574.2010.00251.x
- Issue published online: 17 JAN 2011
- Article first published online: 17 JAN 2011
- Received 15 June 2010; accepted 28 July 2010
- hepatic resection;
- discharge disposition;
Background: There is a paucity of data on the trends in discharge disposition for patients undergoing hepatic resection for malignancy.
Aim: To analyse the national trends in discharge disposition after hepatic resection for malignancy.
Methods: The National Inpatient Sample (NIS) database was queried (1993 to 2005) to identify patients that underwent hepatic resection for malignancy and analyse the discharge status (home, home health or rehabilitation/skilled facility).
Results: A weighted total of 74 520 patients underwent hepatic resection of whom, 53 770 patients had a principal diagnosis of malignancy. The overall mortality improved from 6.3% to 3.4%. After excluding patients that died in the post-operative period and those with incomplete discharge status, 45 583 patients were included. The proportion of patients that had acute care needs preventing them from being discharged home without assistance increased from 10.9% in 1993 to 19.5% in 2005. While there was an increase in the number of patients discharged to home health care during this time (8.9% to 13.8%), there was a larger increase in the proportion of patients that were discharged to a rehabilitation or skilled nursing facility (2% to 5.7%). Despite a decrease in the mortality rates, there was no improvement in rate of patients discharged home without assistance over the period of the study.
Conclusions: The results of the present study demonstrate that after hepatic resection, a significant proportion of patients will need assistance upon discharge. This information needs to be included in patient counselling during pre-operative risk and benefit assessment.