The 30-day hospital readmission and mortality after surgery in colorectal cancer patients

Abstract

Purpose Hospital readmissions in the first weeks following surgery are common, expensive, and associated with increased mortality among colorectal cancer patients. This study is designed to assess the 30-day hospital readmission after colorectal cancer surgery and evaluate the risk factors that affect hospital readmission. Methods The study uses data from the Ministry of National Guard-Health Affairs Cancer Registry. All colorectal cancer patients who underwent colorectal cancer surgery between January 1, 2016, and November 31, 2021, were investigated. Factors examined were age, gender, marital status, Body Mass Index, Charlson Comorbidity Index, chemotherapy, radiotherapy, tumor stage, grade, site, surgical approach, length of stay, and discharge location. Kaplan–Meier curves were constructed to assess survival rates between readmitted and non-readmitted patients, and logistic regressions were performed to assess predictors of readmission. Results A total of 356 patients underwent tumor resection and 49 patients were readmitted within 30-day of index discharge. The most common reasons for hospital readmissions were gastrointestinal (22.45%), urinary tract infection (16.33%), and surgical site infection (12.24%). In the multivariable analysis, females were 89% more likely to be readmitted compared to males (odds ratio 1.89, 95% confidence intervals 1.00–3.58). Patients with distant metastatic tumors have higher odds of readmission (odds ratio 4.52, 95% confidence intervals 1.39–14.71) compared to patients with localized disease. Conclusions Colorectal cancer readmission is more common in patients with metastatic disease. Strategies to reduce readmission include planned transition to outpatient care, especially among patients with a high risk of readmission.

Ambulatory Robotic Colectomy: Factors Affecting and Affected by Postoperative Opioid Use

“…The cohort’s small ROU and early discharge nevertheless appeared to produce low rates of readmission. In our study, 5% of patients were readmitted, which compares favorably to literature readmission rates that range from 7% to 25% 17–20 . Some older studies had previously identified early discharge as a significant risk factor for readmissions after colectomy 8,9 .…”

“…In our study, 5% of patients were readmitted, which compares favorably to literature readmission rates that range from 7% to 25%. [17][18][19][20] Some older studies had previously identified early discharge as a significant risk factor for readmissions after colectomy. 8,9 These studies, however, predated evolutions in robotic surgical technique and did not test a specific, tailored protocol for SDD.…”

Allostatic Load as a Predictor of Postoperative Complications in Patients with Breast Cancer

“…40,41 The impact of marital status on POC development varies among other cancer types; divorced or separated patients with oropharyngeal or laryngeal cancer have twice the odds of requiring readmission for complications but no association is seen amongst patients with colorectal cancer. 42,43 Yu et al noted that patients with breast cancer with government insurance, particularly Medicare, were also more likely to develop POC even after controlling for age and comorbidities. 44 Additional work is needed to determine the pathways between insurance, marital status, and POC.…”

Factors Influencing Readiness for Hospital Discharge among Patients Undergoing Enterostomy: A Descriptive, Cross-sectional Study

“…Early postoperative hospital readmissions are also common, costly, and associated with increased mortality rates. [11][12][13] Research has shown that up to 27% of cancer patients discharged from hospitals are readmitted, 14 contributing to the healthcare burden in morbidity and mortality. 11 During the COVID-19 pandemic, most surgical procedures were performed for emergency or oncologic reasons to the detriment of the remaining elective procedures for benign conditions.…”

“…As a result, their QoL deteriorates from a lack of self-care knowledge and perspective on ostomy self-management. Early postoperative hospital readmissions are also common, costly, and associated with increased mortality rates 11–13 . Research has shown that up to 27% of cancer patients discharged from hospitals are readmitted, 14 contributing to the healthcare burden in morbidity and mortality 11 …”