Objectives: Unplanned hospital readmission can lead to excess economic burden among patients with mPDAC. This study aimed to describe the frequency of 30-day readmission among patients with mPDAC who received systemic treatment.

Methods: This retrospective observational study utilized the IBM MarketScan Commercial and Medicare supplemental claims databases. Data were analyzed for adult patients who were diagnosed with mPDAC and received systemic treatment between January 2015 and March 2020 and experienced a hospital admission during treatment. Patient demographic characteristics were assessed. The frequency of intensive care unit (ICU) admissions, readmission events, and primary discharge diagnoses associated with readmission were described.

Results: 2,561 patients with mPDAC treated with first line therapy (1L) were included. Of those patients treated with 1L, 1,085 received second line therapy (2L), and 373 received third line therapy (3L). Readmissions occurred in 22.7% (n=581) patients treated in 1L, 25.8% (n=280) of patients treated in 2L, and 25.5% (n=95) of patients treated in 3L. ICU admissions occurred in 17.3%, 18.5%, and 17.7% of initial admissions among patients treated in 1L, 2L, and 3L, respectively. Among 1L regimens, the readmission rate was 24.9% for patients treated with FOLFIRINOX, 22.1% for those treated with gemcitabine plus nab-paclitaxel, and 21.5% for those who received gemcitabine monotherapy. Among 2L regimens, those treated with liposomal irinotecan-based regimens had the lowest readmission rates (16.4%). Common primary diagnoses which led to readmissions across all lines of therapy were pancreatic cancer (14.1%), sepsis (9.8%), metastases (7.7%), and symptomatic complications (5.2%) [e.g nausea/vomiting, fever].

Conclusions: This real-world study found between 20-25% of patients who are hospitalized while receiving treatment for mPDAC will experience a readmission. The rate of readmission in the 2L setting was lowest among patients who received liposomal irinotecan-based regimens. Further studies are needed to characterize the burden and predictors of readmissions among patients with mPDAC.