Readmission Rates and Cost Following Colorectal Surgery

Wick, Elizabeth C.; Shore, Andrew D.; Hirose, Kenzo; Ibrahim, Andrew M.; Gearhart, Susan L.; Efron, Jonathan E.; Weiner, Jonathan P.; Makary, Martin A.

doi:10.1097/dcr.0b013e31822ff8f0

Cited by 275 publications

(172 citation statements)

References 8 publications

Supporting

Mentioning

153

Contrasting

Unclassified

Order By: Relevance

“…Hanzlik et al have suggested that protocolized peri-operative teaching, such as the "Ileostomy pathway" which has been shown to reduce readmission rates in patients with new ostomies should be adopted in these cases. 16,17,22,[24][25][26][27] Of the post-operative complications, renal complications and urinary tract infections (7.6% each), were found to be significant risk factors for readmission and the similar findings were observed by Kassin et al as well. 3 Kelly et al also found that UTI was a significant factor for readmission.…”

Section: Discussionsupporting

confidence: 76%

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

et al. 2017

View full text Add to dashboard Cite

Background: Unforeseen re-admissions are a consequence of natural course of patient’s disease or results from sub-optimal care during first admission. Apart from causing increased expenditure, readmission immensely adds to the distress of the patient as well as his relatives. The aim of the study was to assess the incidence and risk factors for 30-day unplanned readmission following emergency laparotomy for perforation peritonitis.Methods: This prospective observational study was conducted on 145 patients undergoing laparotomy for perforation peritonitis in over a period of two years. Various pre-operative, intra-operative and post-operative parameters were studied to identify the risk factors for readmission.Results: Overall readmission rate was 8.96% and in majority of the cases it was due to post-surgical complications. Various factors found significant for readmission were American Society of Anaesthesiology (ASA) grade (p = 0.014) hypoproteinemia (p<0.001), diabetes mellitus (p = 0.001), immuno compromised status (p<0.001), stoma creation (p<0.001), blood transfusion (p = 0.022), renal complications and UTI (p = 0.027 each). On multivariate analysis, hypoproteinemia and stoma creation were found to be significant.Conclusions: Risk factors for readmission among surgical patients are multi-factorial. Taking appropriate steps can reduce the burden of readmission. Moreover decreasing the rate of surgical readmission represents an opportunity to improve patient care.

show abstract

Section: Discussionsupporting

confidence: 76%

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Readmissions have economic implications: a recent analysis estimated a nationwide readmission cost of $300 million annually for colorectal surgery. 15 Readmissions after pancreatic resections on average cost $16 000 16 ; surgical site infections alone add up to $5000 in health care costs per infection. 17,18 We identified potential targets for future interventions intended to improve outcomes of surgical patients in the PD period.…”

Section: Commentmentioning

confidence: 99%

Association of Postdischarge Complications With Reoperation and Mortality in General Surgery

Kazaure¹,

Roman²,

Sosa³

2012

Arch Surg

105

View full text Add to dashboard Cite

“…As an indicator of medical care, readmission rate after colorectal cancer surgery reflecting late complications and breach of initial care can be seen in up to 24 % of the patients (5)(6)(7). Data with regard to readmission of the patients after colorectal surgery may give important information following oncologic and surgical outcomes (8).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for readmission following colorectal cancer surgery

Hasbahçeci¹,

İdiz²,

Cengiz³

et al. 2017

Acta Oncol Tur.

View full text Add to dashboard Cite

ÖZET Amaç: Kolorektal kanser cerrahisi sonrası yeniden başvurunun görülme sıklığı ve oluşumu için yüksek riskli hasta gruplarının tanımlanması için gerekli parametreler halen net olarak belirlenmemiştir. Gereç ve Yöntemler: Bu çalışma, prospektif bir veri tabanı kullanılarak kolorektal kanser cerrahisi geçirmiş olan hastaların retrospektif analizidir. Taburculuktan sonraki ilk 30 gün içerisinde hastane yatışı gerektiren yeniden başvuru asıl değişken olarak belirlendi. Bulgular: Toplam 187 kolorektal kanser cerrahisi geçiren hasta dikkate alındığında, yaş ortalaması 59,9±13,5 yıl olan 17 hasta (%9%), taburculuk sonrası ortalama 11,6±8,2 gün sonra yeniden hastaneye yatırıldı. Yeniden başvurunun en sık rastlanılan etyolojik sebepleri arasında enfektif komplikasyonlar (n=5), eviserasyon (n=3), anastomoz problemleri (n=3) ve intraabdominal kanama/asit gelişimi (n=3) yer almaktaydı. Yeniden başvuru ile erkek cinsiyet (p=0.033), açık cerrahiye dönüş (p=0.009), ilk yatış esnasında herhangi bir komplikasyon gelişimi (p=0.025), herhangi bir eş zamanlı çoklu organ rezeksiyon gerekliliği (p=0.048) ve T evresi (p=0.046) arasında anlamlı ilişki olduğu gösterildi. Lojistik regresyon analizi, bu faktörler arasından erkek cinsiyet (p=0.041) ve herhangi bir eş zamanlı çoklu organ rezeksiyon gerekliliğinin (p=0.045) yeniden başvuru gelişimi ile anlamlı bir şekilde ilişkili olduğunu gösterdi. Sonuç: Her ne kadar erkek cinsiyet ve herhangi bir eş zamanlı çoklu organ rezeksiyon gerekliliğinin yeniden başvuru gelişimi ile anlamlı bir şekilde ilişkili olduğu gösterilmekle birlikte, kişisel risk faktörlerinin belirlenmesi için ileri çalışmalara ihtiyaç vardır. Anahtar kelimeler: yeniden başvuru, kolorektal kanser, kolorektal cerrahi, komplikasyon ABSTRACT Objective: Incidence of re-admission after colorectal cancer surgery and the parameters to define high-risk patients for its occurrence remain to be clarified. Material and Methods: This study was a retrospective analysis of patients with colorectal cancer surgery using a prospective database. Readmission necessitating hospitalization within the first 30 days following discharge was regarded as major outcome. Results: Considering a total of 187 colorectal cancer patients, 17 (9%) with a mean age of 59.9±13.5 years were re-hospitalized after a mean of 11.6±8.2 days following discharge. Infective complications (n=5), evisceration (n=3), anastomotic problems (n=3) and intraabdominal hematoma/ascites (n=3) were the most commonly encountered surgical etiologies for readmission. There was a close relationship between readmission and male sex (p=0.033), conversion to open surgery (p=0.009), development of any type of complication during index admission (p=0.025), need for concurrent multi-organ resections of any type (p=0.048) and T stage (p=0.046). Logistic regression analysis showed that male sex (p=0.041) and need for concurrent multi-organ resections of any type (p=0.045) were significantly related with development of readmission. Conclusion: Although male sex and need for concurrent mult...

show abstract

Readmission Rates and Cost Following Colorectal Surgery

Cited by 275 publications

References 8 publications

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

Association of Postdischarge Complications With Reoperation and Mortality in General Surgery

Risk factors for readmission following colorectal cancer surgery

Contact Info

Product

Resources

About