3:18 PM Abstract No. 101 30-day readmission rates following percutaneous transhepatic biliary drainage catheter placement

Abstract

To retrospectively analyze all-cause 30-day readmission rates for patients undergoing percutaneous transhepatic biliary drainage catheter (PTBD) placement. Prior literature has suggested high complication rates following PTBD placement. A total of 238 PTBD procedures for 212 patients over a 5-year period from a single institution were retrospectively reviewed from the electronic health record. Variables analyzed included number of days to readmission following discharge from index admission, reason for readmission, and whether readmission was planned or unplanned and IR- or non-IR related. Additional variables analyzed included demographic data, etiology of biliary obstruction, laterality of access, and initial catheter size. The number of days to 30-day readmission post discharge ranged from 2 to 28 days, with a mean of 12.9 days. Of the 67 readmissions, 36 (53.7%) were secondary to malignant and 31 (46.3%) were for benign obstruction. Causes of IR-related readmission were suspected cholangitis (48.5%), leakage or drainage around catheter exit site (27.3%), drain malposition/malfunction (9.1%), and right upper quadrant abdominal pain (6.1%). See table below. PTBD procedures for both benign and malignant disease are associated with high rates of 30-day readmissions, a significant number of which are unplanned and IR-related. This has major implications on quality, safety, and reimbursement and implies the potential for improved post procedure care following PTBD procedures in order to reduce readmission rates.Tabled 1Total number of primary PTBD procedures238Malignant obstruction122 (51.3%)Benign obstruction116 (48.7%)All-cause 30-day readmission67 (28.2%)IR-related readmissions33 (49.3% of readmissions; 13.9% of total)Unplanned IR-related readmissions30 (90.9% of IR-related readmissions; 12.6% of total) Open table in a new tab