Some Surgery Patients Boomerang Back to Hospital

Post surgery complications like infection and bleeding may send some patients back to hospital

(RxWiki News) Surgical complications could make some patients boomerang back to the hospital. And health care professionals are working to improve care for these patients.

A new study has found that complications related to surgery are the most common reason for a patient to be readmitted. Researchers from the American College of Surgeons noted that their findings offered a chance to make improvements.

"However, surgical readmissions mostly reflect postdischarge complications, and readmission rates may be difficult to reduce until effective strategies are put forth to reduce common complications such as [infection]," the authors of this study wrote. "Efforts should focus on reducing complication rates overall than simply those that occur after discharge, and this will subsequently reduce readmission rates as well.”

Lead study author Ryan P. Merkow, MD, of the American College of Surgeons in Chicago, and colleagues studied data from nearly 500,000 surgeries from hospitals across the US. Almost 6 percent of all patients in this study were readmitted because of a complication that occurred after they left the hospital.

The most common reason for patients to be readmitted after any surgery was an infection at the surgery site, Dr. Merkow and colleagues found. Almost 20 percent of patients who were readmitted within 30 days of surgery had an infection.

Infection rates for some surgeries were even higher — 28.8 percent for hysterectomy and 36.4 percent for lower vascular bypass, for instance. In a hysterectomy, all or part of the uterus is removed. Vascular bypass uses human or artificial blood vessel grafts to provide a new channel for blood to flow to the lower leg.

Of the patients who were readmitted, only 2.3 percent came back due to a complication they had experienced in the hospital. Most were readmitted for new problems.

After infection, patients who had abdominal surgeries were most likely to be readmitted for an intestinal obstruction. Bleeding was the third most common reason for readmission in all surgeries.

Those who had a complication while in the hospital were also more likely to be readmitted. However, the reason for the readmission was not often tied to the hospital complication.

In an editorial about this study, Lucian L. Leape, MD, of the Harvard School of Public Health in Boston, wrote that “an important question is how can the data be used to reduce the pain and suffering that complications cause for patients?”

Dr. Leape added, “The most powerful methods for reducing harm are feedback, learning from the best, and working in collaboration.”

The study and editorial were published online Feb. 3 in JAMA.

Some study authors received grants or fees from the American College of Surgeons and other groups. None of the authors declared a conflict of interest.

Review Date: 
February 2, 2015