Hospital-based, acute care encounters after radiofrequency ablation of hepatic tumours

HPB (Oxford). 2014 Sep;16(9):845-51. doi: 10.1111/hpb.12220. Epub 2014 Jan 28.

Abstract

Background: The use of radiofrequency ablation (RFA) for cancer is increasing; however, post-discharge outcomes have not been well described. The aim of the present study was to determine rates of hospital-based, acute care utilization within 30 days of discharge after RFA.

Methods: Using state-level data from California, patients were identified who were at least 40 years of age who underwent RFA of hepatic tumours without a concurrent liver resection from 2007-2011. Our primary outcome was hospital readmissions or emergency department visits within 30 days of discharge. A multivariable regression model was constructed to identify patient factors associated with these events.

Results: The final sample included 1764 patients treated at 100 centres. Hospital readmissions (11.3/100 discharges), emergency department visits (6.0/100 discharges) and overall acute care utilization (17.3/100 discharges) were common. Most encounters occurred within 10 days of discharge for diagnoses related to the procedure. Patients with renal failure [adjusted odds ratio (AOR) = 1.98 (1.11-3.53)], obesity [AOR = 1.69 (1.03-2.77)], drug abuse [AOR = 2.95 (1.40-6.21)] or those experiencing a complication [AOR = 1.52 (1.07-2.15)] were more likely to have a hospital-based acute care encounter within 30 days of discharge.

Conclusions: Hospital-based acute care after RFA is common. Patients should be counselled regarding the potential for acute care utilization and interventions targeted to high-risk populations.

MeSH terms

  • Adult
  • Aged
  • California
  • Catheter Ablation / adverse effects*
  • Emergency Service, Hospital* / statistics & numerical data
  • Female
  • Hospitals* / statistics & numerical data
  • Humans
  • Liver Neoplasms / surgery*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Discharge
  • Patient Readmission*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome