
pmid: 39164121
The aim of this study was to assess the predictive value of discharge C-reactive protein (CRP) and white blood cell (WBC) levels for 90-day readmission after pancreatoduodenectomy (PD).A two-centre, retrospective study was performed between 2008 and 2022. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive value of CRP level and WBC count at discharge. A conditional inference tree (CTREE) was constructed to identify combined risks within subgroups using variables associated with readmission.Of 438 patients, 54 (12%) were readmitted. The median WBC count at discharge was comparable between the readmitted and not readmitted groups (9.1 vs. 8.5 G/l). The CRP levels at discharge were predictive of 90-day readmission, with an area under the ROC curve (AUC) of 0.63 (95% CI: 0.55-0.63). A CRP concentration below 105 mg/l ruled out 90-day readmission, with a negative predictive value (NPV) of 90% (95% CI: 81%-95%). CTREE confirmed the diagnostic value of CRP at discharge (AUC = 0.68, 95% CI 0.60-0.68). CTREE additionally identified previous wound infection as a second risk factor for readmission in patients with CRP levels less than 101 mg/l (P = 0.003).CRP levels below 105 mg/l at discharge allow for a safe discharge with a low 90-day readmission rate. Wound infection, but not WBC count, was a positive predictor of 90-day readmission with moderate accuracy, suggesting the need for predischarge imaging for undetected complications in this patient cohort.Our retrospective analysis did not require registration with a publicly accessible registry.
Male, Time Factors, Decision Trees, 610 Medicine & health, Middle Aged, Patient Readmission, Risk Assessment, Patient Discharge, Pancreaticoduodenectomy, Leukocyte Count, C-Reactive Protein, Treatment Outcome, Postoperative Complications, Predictive Value of Tests, Risk Factors, Humans, 2721 Hepatology, 2715 Gastroenterology, Female, Biomarkers, 10217 Clinic for Visceral and Transplantation Surgery, Retrospective Studies, Aged
Male, Time Factors, Decision Trees, 610 Medicine & health, Middle Aged, Patient Readmission, Risk Assessment, Patient Discharge, Pancreaticoduodenectomy, Leukocyte Count, C-Reactive Protein, Treatment Outcome, Postoperative Complications, Predictive Value of Tests, Risk Factors, Humans, 2721 Hepatology, 2715 Gastroenterology, Female, Biomarkers, 10217 Clinic for Visceral and Transplantation Surgery, Retrospective Studies, Aged
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