Multivariable analysis of factors associated with hospital readmission after intestinal surgery

Yehuda Kariv, Wei Wang, Anthony J. Senagore, Jeffrey P. Hammel, Victor W. Fazio, Conor P. Delaney

    Research output: Contribution to journalArticle

    88 Scopus citations

    Abstract

    Background: Readmission rates after major abdominal surgery have a significant impact on hospital costs and quality of care. Identification of risk factors for readmission may improve postoperative care and discharge plans. Methods: One hundred fifty consecutive patients readmitted within 30 days of discharge after intestinal surgery (RD) were compared with matched nonreadmitted patients. Patient-related (demographic, comorbidity, medications), disease-related (diagnosis, type of surgery), and perioperative course variables were collected for logistic regression analysis. Results: RD was associated with chronic obstructive pulmonary disease (odds ratio [OR] 7.12 and 95% confidence interval [CI] 1.4-37.6), worse functional capacity class (OR 2.02 and CI 1.15-3.56), previous anticoagulant therapy (OR 4.85 and CI 1.2-19.7), steroid treatment, and discharge to a facility other than home (OR 4.35 and CI 0.97-20.0, P = .055). In patients with intestinal perforation, RD rate was decreased (OR 0.3 and CI 0.1-0.9), but this was associated with a longer primary hospital stay (median 8 vs. 6 days, P = .12). RD causes included surgical site septic complications (33%), ileus and/or small-bowel obstruction (23%), medical complications (24%), and others (20%). Conclusions: Functional capacity, chronic obstructive pulmonary disease, previous anticoagulant therapy, perioperative steroids, and discharge destination are independent predictors of RD. Disease-related factors have minor impact on RD rates. Improving functional status before surgery, decreasing the adverse impact of steroids, and/or stratifying perioperative anticoagulant use may decrease unexpected readmissions in this patient population.

    Original languageEnglish (US)
    Pages (from-to)364-371
    Number of pages8
    JournalAmerican Journal of Surgery
    Volume191
    Issue number3
    DOIs
    StatePublished - Mar 1 2006

    Keywords

    • Colorectal surgery
    • Postoperative care
    • Readmission
    • Risk factors

    ASJC Scopus subject areas

    • Surgery

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    Kariv, Y., Wang, W., Senagore, A. J., Hammel, J. P., Fazio, V. W., & Delaney, C. P. (2006). Multivariable analysis of factors associated with hospital readmission after intestinal surgery. American Journal of Surgery, 191(3), 364-371. https://doi.org/10.1016/j.amjsurg.2005.10.038