Unplanned Hospital Trips After GI Surgery

Gastrointestinal resection factors up odds of being readmitted to hospital within 30 days

(RxWiki News) It's a major decision to go under the knife for surgery. For patients undergoing a gastrointestinal (GI) resection to remove abnormal or cancerous tissues, a lot of factors should be considered.

A recent study found that patients who have major complications after surgery were much more likely to be readmitted to the hospital within 30 days.

These findings showed which factors might prevent hospital re-admissions in select high-risk patients having the procedure, according to the researchers.

"Ask your surgeon about the risks before an operation."

Kristin N. Kelly, MD, from the Surgical Health Outcomes & Research Enterprise and the Division of Colorectal Surgery at University of Rochester Medical Center in New York, led an investigation into the patient characteristics, surgery factors and complications after surgery that were linked with 30-day readmission rates in gastrointestinal resections.

The researchers looked at results from more than 43,000 patients undergoing GI resection who were selected from the 2011 ACS National Surgical Quality Improvement Program database.

The researchers grouped patients based on the type of procedure they had. Procedure types included esophageal, gastric, small bowel, large bowel, liver and pancreatic resections, based on the Common Procedural Terminology codes.

The number of complications that occurred after surgery was tracked. The researchers categorized the complications as either pre- or post-discharge based on when they occurred.

The researchers also tracked illnesses related to the procedures, surgical characteristics and post-operative complications that caused an unplanned hospital readmission within 30 days of having surgery.

On average, 12 percent of patients who had gastrointestinal resection had unplanned readmissions to the hospital within 30 days, the researchers found.

Colorectal surgery patients had the lowest percentage of unplanned hospital readmissions, with 11.4 percent readmitted. Pancreatic resections had the most, with 15.7 percent of patients readmitted.

Patients who used steroids before surgery or were discharged to a facility other than home were 28 and 48 percent more likely to be readmitted to the hospital.

Patients who had operations lasting longer than four hours were 61 percent more likely to be readmitted.

Patients who had open surgery, diabetes or preoperative anemia were likelier to be readmitted to the hospital.

Other factors that were linked with increased readmission included having some neurological (brain) or pulmonary (lungs) illness. 

"Unplanned 30-day readmissions represent a major medical and financial concern, but some may be foreseeable and thus preventable," the researchers wrote in their report. "Although previous studies have identified major complications as a strong risk factor for readmissions, this might represent an overestimate of the risk due to confounding by including post-discharge complications that may in fact cause, not predict, readmissions."

The odds that patients would be readmitted to the hospital increased six-fold in those who had minor complications after being discharged initially after surgery.

Patients with major complications were 59.3 times more likely to be readmitted to the hospital.

This study was presented May 18 during Digestive Disease Week in Bethesda, Maryland. No conflicts of interest were reported.

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Review Date: 
May 19, 2013