Evidence map›Paper›PMID 40833541›Full record

ArticleAnnals of surgical oncology2026

Patterns and Consequences of Care Fragmentation in Post-Surgical Management of Upper Gastrointestinal and Hepatopancreatobiliary Cancers.

Melissa Justo, Konmal Ali, Sara Sakowitz, Ayesha Ng, Sona Mahrokhi, Syed Shaheer Ali, Peyman Benharash, Mark D Girgis

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Melissa JustoDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Konmal AliDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Sara SakowitzDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Ayesha NgDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Sona MahrokhiDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Syed Shaheer AliDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Peyman BenharashDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Mark D GirgisDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. mdgirgis@mednet.ucla.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUpper gastrointestinal (UGI) and hepatopancreatobiliary (HPB) oncologic operations are frequently performed at major referral centers. Postoperatively, many patients face care fragmentation (CF), which has been previously linked to inferior outcomes. This analysis examines clinical and financial outcomes of CF following UGI and HPB cancer operations. PATIENTS AND

methodsThe 2016-2022 Nationwide Readmissions Database identified adults (≥ 18 years) who underwent UGI and HPB oncologic surgery. Patients readmitted to a nonindex facility within 30 days of discharge comprised the CF cohort. Multivariable models assessed the association of CF with clinical outcomes and identified related factors.

resultsAmong 8384 UGI and 16,235 HPB surgical oncology patients, CF affected 15.2% and 13.3%, respectively. CF was associated with higher rates of major adverse events in both groups. Patients undergoing the UGI procedure showed increased odds of respiratory complications (adjusted odds ratio [AOR] 1.67, 95% confidence interval [CI] 1.34, 2.09), while patients undergoing the HPB procedure experienced higher risks of in-hospital mortality (AOR 1.84, 95% CI 1.15-2.94), cardiac (AOR 1.74 95% CI 1.12, 2.71), and respiratory (AOR 2.45, 95% CI 1.87, 3.21) complications. CF was not associated with increased hospitalization costs or longer stays in either cohort.

conclusionsCF significantly affects postoperative outcomes following UGI and HPB cancer surgeries, with differential impacts between cohorts. The lack of association with increased costs or longer hospital stays may reflect suboptimal care continuity rather than equivalent efficiency. Given CF's persistent prevalence and clinical significance, these findings highlight the need for enhanced interhospital coordination to improve outcomes for complex oncologic surgical patients.

Indexed as

Biliary Tract NeoplasmsDigestive System Surgical ProceduresGastrointestinal NeoplasmsLiver NeoplasmsPancreatic NeoplasmsPatient ReadmissionPostoperative CarePostoperative ComplicationsAgedFemaleFollow-Up StudiesHospital MortalityHumansLength of StayMaleMiddle AgedCare fragmentationEsophageal cancerGastric cancerHepatopancreatobiliaryNationwide readmission databaseUpper gastrointestinal

Identifiers

PMID40833541
PMCPMC12689737

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.