Risk Factors of Unplanned Readmission After Colorectal Surgery: A Prospective, Multicenter Study

Abstract

The study permitted to individualize several factors significantly associated with a higher risk of unplanned readmission after colorectal surgery.

Risk factors for readmission following colorectal cancer surgery

“…In our center, any type of enhanced recovery or fasttrack protocols have not been applied to our patients. Although it was thought that most of the unplanned readmissions were linked to an early discharge and shorter hospital stay, this finding was not observed by other researchers (12,13,(18)(19)(20). There are some authors who advocate that decreasing the duration of hospital stay of the patients after colorectal surgery would help to reduce the expenses related to health, to prevent nosocomial infections and to increase the quality of patient's life by sending him/her to home quickly (10).…”

“…It is generally accepted that surgical patients are at high risk for readmission due to the increased risks of infection, anastomotic leak, ileus, re-bleeding, and thromboembolic events (12). Therefore, recent studies have focused on 30-day readmission rates after several surgical operations including colorectal surgery as a marker of quality of surgical care (12,13). It was also believed that delayed surgical and medical complications appearing Adress for correspondence: Dr. Mustafa Hasbahçeci Bezmialem Vakıf University Faculty of Medicine Department of General Surgery, İstanbul, Turkey e-mail: hasbahceci@yahoo.com Available at www.actaoncologicaturcica.com Copyright ©Ankara Onkoloji Hastanesi within a month after discharge were the most important cause for the unplanned readmissions.…”

“…It was also believed that delayed surgical and medical complications appearing Adress for correspondence: Dr. Mustafa Hasbahçeci Bezmialem Vakıf University Faculty of Medicine Department of General Surgery, İstanbul, Turkey e-mail: hasbahceci@yahoo.com Available at www.actaoncologicaturcica.com Copyright ©Ankara Onkoloji Hastanesi within a month after discharge were the most important cause for the unplanned readmissions. In addition, the real incidence of re-admission seems to be difficult to assess because of differences in methodology, time frames for readmission, patient groups, and in whether planned readmissions were included (11,13). Therefore, unplanned re-admissions within the postoperative 30 days were studied in the present study to evaluate readmissions caused by surgical and medical complications.…”

“…In a meta-analysis, it has been shown that implementation of the enhanced recovery after surgery pathways in colorectal surgery caused 12% reduction in total complication rates without compromising patient safety (18). It was also interesting to find increased readmissions in cases with longer hospital stay caused either by surgical complications during the index admission or initially older and sicker patients (8,10,13). In an English NHS trust study with a period of ten years, the relationship between length of hospital stay and subsequent readmission after major elective colorectal surgery was shown to be statistically insignificant (14).…”

“…Defining the high-risk patient based on the factors directly related with readmission may be the most important preventive measure, although there were numerous studies which attempted to identify predictors or early readmission with mixed results (13). In previous studies, it was shown that it was possible to estimate the future re-admissions with the presence of some risk factors including longer operating time, older patient, higher body mass index, development of any complication during the index admission, identity of the surgeon and increased need of blood transfusions (6,8,15,21,22).…”