Readmissions after colorectal surgery cannot be predicted

Azimuddin, Khawaja; Rosen, Lester; Reed, James F.; Stasik, John J.; Riether, Robert D.; Khubchandani, Indru T.

doi:10.1007/bf02235480

Cited by 85 publications

(68 citation statements)

References 9 publications

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“…In particular, it is necessary to perform periodic follow-up studies in clinics after total gastrectomy in order to assess patients' abdominal symptoms and eating conditions and to intervene in order to prevent malnutrition. A previous report described that 80 % of unexpected readmissions occurred within 30 days, and 50 % of these were within 7 days after discharge in colorectal cancer patients [7,22]. However, regarding specific gastric surgery findings, our study revealed that the incidence of readmissions occurred continuously for up to 6 months postoperatively, because the commonest reasons were malnutrition caused by severe sequelae after gastrectomy.…”

Section: Discussioncontrasting

confidence: 54%

Unplanned admission after gastrectomy as a consequence of fast-track surgery: a comparative risk analysis

et al. 2015

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Background The objectives of this study were to evaluate the incidence of and the risk factors for readmission after gastrectomy. Our hypothesis was that early discharge may be related to an increase in the incidence of readmission. Methods This was a retrospective, single-center, observational study of 1442 patients who underwent gastrectomy for stage I gastric cancer. The main outcome was the incidence of early readmission after gastrectomy, which was defined as an admission within 6 months after the first discharge day. A stepwise logistic regression analysis was conducted to identify the risk factors for readmission after gastrectomy. Results The surgical procedures performed were total gastrectomy in 217 patients (15.0 %), distal gastrectomy in 845 patients (58.6 %), pylorus-preserving gastrectomy in 342 patients (23.7 %), and proximal gastrectomy in 37 patients (2.6 %). The median hospital stay was 11 days, and there were 63 readmissions for a total of 56 patients (3.8 %). The main reasons for readmission were poor food intake in 14 patients (22.2 %), anastomotic stricture in nine patients (14.3 %), small bowel obstruction in eight patients (12.7 %), and an abdominal distension in seven patients (11.1 %). Endoscopic balloon dilation was performed for the nine patients with anastomotic stricture, drainage was needed for the four patients with an intra-abdominal abscess, and laparotomy was performed for one patient with adhesion-associated bowel obstruction. The long hospitalization during the primary admission and patients who underwent total gastrectomy were risk factors for readmission. Conclusions Patients with a long hospital stay after gastrectomy are at an increased risk of early readmission, which was likely related to the incidence of severe sequelae specific to gastrectomy.

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Section: Discussioncontrasting

confidence: 54%

Unplanned admission after gastrectomy as a consequence of fast-track surgery: a comparative risk analysis

et al. 2015

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“…The incidence of readmissions within 30 days after colorectal surgery has ranged in the literature from 7 to 10% [34,35]. Although we had high-risk patients in our cohort, the overall 30-day readmission rate was similar to that of previous reports (8.4%), and no significant difference was detected between OC and LC patients.…”

Section: Discussionsupporting

confidence: 86%

Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs

et al. 2009

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“…22 Moreover, POI is one of the most common causes of prolonged hospitalization after abdominal surgery, thus increasing health care resource utilization, and may be a significant causative or contributing factor for hospital readmissions. 5,[23][24][25] Alvimopan is a novel, oral, peripherally acting antagonist of the mu opioid receptor, which is being evaluated in Phase III trials for the management of POI. 26,27 In early studies, alvimopan did not interfere with centrally mediated effects of opioids, such as analgesia and pupillary size.…”

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confidence: 99%

Phase III Trial of Alvimopan, a Novel, Peripherally Acting, Mu Opioid Antagonist, for Postoperative Ileus After Major Abdominal Surgery

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et al. 2005

Diseases of the Colon &Amp; Rectum

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Readmissions after colorectal surgery cannot be predicted

Cited by 85 publications

References 9 publications

Unplanned admission after gastrectomy as a consequence of fast-track surgery: a comparative risk analysis

Unplanned admission after gastrectomy as a consequence of fast-track surgery: a comparative risk analysis

Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs

Phase III Trial of Alvimopan, a Novel, Peripherally Acting, Mu Opioid Antagonist, for Postoperative Ileus After Major Abdominal Surgery

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