Why Are Patients Readmitted After Surgery for Gastric Cancer? Predictors of 30-Day Readmission Following Gastrectomy: A Single-Center Retrospective Cohort Study.

Abstract

Objective: Gastric cancer (GC) remains a major global health concern, with gastrectomy serving as the primary curative intervention. Early hospital readmission after gastrectomy is an important quality-of-care metric; however, data on its predictors and clinical implications remain limited. This study aimed to evaluate the incidence, timing, causes, and predictors of early readmission (within 30 days) after gastrectomy for GC.

Methods: We conducted a retrospective single-center cohort study of patients who underwent gastrectomy for GC between January 2012 and January 2023. Patients with non-adenocarcinoma histology or cytoreductive/bariatric indications were excluded. The primary outcome was 30-day readmission, defined as inpatient hospitalization within 30 days of discharge. Univariable and multivariable logistic regression models were used to identify predictors of readmission.

Results: Of 416 patients included, 103 (24.8%) presented to the emergency department (ED) within 30 days of discharge, and 72 (17.3%) were readmitted. The most common causes of readmission were intra-abdominal infections (26.4%), gastrointestinal symptoms (20.8%), and bleeding (12.5%). Readmitted patients had a significantly higher Charlson comorbidity index (median: 6 vs. 5, p = 0.002), more postoperative complications (54.2% vs. 38.7%, p = 0.018), and higher 90-day mortality (8.3% vs. 1.2%, p = 0.003). In multivariable analysis, a higher comorbidity burden and postoperative complications showed trends toward association with readmission but did not reach statistical significance.

Conclusions: Thirty-day readmission after gastrectomy was associated with comorbidity burden and postoperative complications. Although these factors did not remain statistically significant in adjusted analyses, they may inform targeted discharge planning and early follow-up. Improved perioperative care and risk-based post-discharge interventions may reduce readmissions and improve outcomes in high-risk patients.