Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis

Abstract

AIMTo determine the incidence of readmission after cholecystectomy using 90 d as a time limit.METHODSWe retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications. We excluded ambulatory cholecystectomy, cholecystectomy combined with other procedures, oncologic disease active at the time of cholecystectomy, finding of malignancy in the resection specimen, and scheduled re-admissions for other unrelated pathologies.RESULTSWe analyzed 1423 patients. There were 71 readmissions in the 90 d after discharge, with a readmission rate of 4.99%. Sixty-four point seven nine percent occurred after elective surgery (cholelithiasis or vesicular polyps) and 35.21% after emergency surgery (acute cholecystitis or acute pancreatitis). Surgical non-biliary causes were the most frequent reasons for readmission, representing 46.48%; among them, intra-abdominal abscesses were the most common. In second place were non-surgical reasons, at 29.58%, and finally, surgical biliary reasons, at 23.94%. Regarding time for readmission, almost 50% of patients were readmitted in the first week and most second readmissions occurred during the second month. Redefining the readmissions rate to 90 d resulted in an increase in re-hospitalization, from 3.51% at 30 d to 4.99% at 90 d.CONCLUSIONThe use of 30-d cutoff point may underestimate the incidence of complications. The current tendency is to use 90 d as a limit to measure complications associated with any surgical procedure.

Incidence of and Risk Factors for Multiple Readmissions after Kidney Transplantation

“…5 Other surgical specialties have also sought to define readmission within 90 days postoperatively. [12][13][14][15] Late hospital readmissions (after the initial 30 days) tend to be increasingly related to patient wellness and comorbidities. 5,11 This is specifically important because many transplant patients are predisposed to factors that decrease wellness and increase their susceptibility to readmissions.…”

Postcholecystectomy Biliary Clip Migration Causing Acute Pancreatitis

“…5,6 Moreover, a Spanish study suggested that 6% of all readmissions within 90 days after cholecystectomy were attributable to AP. 7…”

Tasas de readmisión de 90 días después de la colecistectomía: un estudio retrospectivo de cohort

“…A quality standard of < 10% readmission rate after cholecystectomy within the post-operative 30 days has been also recommended 4 . After any medical or surgical treatments, hospital readmission has been regarded as a measure of hospital and surgical quality of care 1,5 .…”

“…The incidence, risk factors, and causes of unplanned hospital readmission after cholecystectomy have been analyzed in the previous studies 1, [3][4][5][8][9][10] . The rate has varied from 2.4% to 6.7%, with an average of 3.3% depending on the different settings of cholecystectomy 7 .…”

“…Although most cholecystectomies have been performed laparoscopically, there are a limited number of studies, in which open cholecystectomy is considered for the calculation of readmission rates following cholecystectomy 1,5 . Thus, analysis of all laparoscopic, open, and converted cholecystectomies regarding hospital readmissions may be used to develop a discharge strategy to define risky patients for hospital readmissions.…”