Nationwide trends, hospital volume, and drivers of survey-weighted 30-day unplanned readmission after pancreatic resection (NRD 2016–2022).

Abstract

e16341 Background: National, survey-weighted benchmarking of 30-day unplanned readmission after pancreatic resection and its relationship with hospital volume remains limited across recent years. Methods: Using NRD 2016–2022, we identified each patient’s first pancreatic resection index admission per calendar year (ICD-10-PCS partial/total resection codes), restricted to 30-day readmission–eligible admissions. Hospital annual resection volume was categorized into year-specific quartiles. We estimated survey-weighted readmission rates and fit survey-weighted logistic regression (weights, hospital clustering, and stratification). Results: Among 28,265 eligible index resections, 2,859 had an observed 30-day unplanned readmission (crude 10.1%). Survey-weighted readmission declined from 10.1% in 2016 to 8.2% in 2022 and was lower in high-volume hospitals (Table 1). In adjusted models, Q4 vs Q1 volume was associated with lower odds of readmission, while extreme APR-DRG severity of illness was associated with higher odds (Table 1). The most common readmission diagnosis categories were Other (50.6%), Postoperative complication (29.4%), and Sepsis/Septicemia (10.5%). Conclusions: Survey-weighted national readmission after pancreatic resection remained near 8–11% and was consistently lower at higher-volume hospitals, supporting targeted transitional-care interventions and dissemination of high-volume program practices. Key survey-weighted estimates (NRD 2016–2022). Domain Comparison / Year Estimate (95% CI) 30-day unplanned readmission rate 2016 0.101 (0.090–0.113) 30-day unplanned readmission rate 2022 0.082 (0.072–0.093) Rate by hospital volume quartile Q1 (lowest) 0.143 (0.114–0.173) Rate by hospital volume quartile Q4 (highest) 0.094 (0.089–0.099) Adjusted odds (survey-weighted logistic) Q4 vs Q1 OR 0.69 (0.54–0.89) Adjusted odds (survey-weighted logistic) Elective vs non-elective OR 0.80 (0.70–0.93) Adjusted odds (survey-weighted logistic) APR-DRG severity extreme vs minor OR 1.72 (1.29–2.29)