Factors associated with unplanned re-admission after elective gastroenterological surgery: an analysis of 1824 participants with clean-contaminated wounds enrolled in two randomized controlled trials for the prevention of surgical site infection.
Natsumi Matsuzawa, Hiroshi Noda, Kosuke Ichida et al.
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In 30 seconds
This analysis examined factors associated with unplanned readmission within 30 days of discharge among patients undergoing elective gastroenterological surgery with clean-contaminated wounds. The 1824 patients were drawn from two randomized controlled trials of interventions to prevent surgical site infection; the readmission analysis used univariate and multivariate methods. Seventy-one patients (3.9%) were readmitted. Postoperative ileus was the most common reported cause, followed by organ/space surgical site infection. Pulmonary disorder was significantly associated with readmission (odds ratio 2.09; 95% confidence interval: 1.26-3.49, P = 0.005).
Key findings
- Unplanned readmission within 30 days occurred in 71 of 1824 patients (3.9%).
- Postoperative ileus accounted for 23.9% of readmissions, organ/space surgical site infection for 22.5%, and dehydration/acute kidney injury for 8.5%.
- Pulmonary disorder was associated with readmission in multivariate analysis (odds ratio 2.09; 95% confidence interval: 1.26-3.49, P = 0.005).
- Of patients with organ/space surgical site infection, 106 (86.9%) developed it during the index stay and 16 (13.1%) after discharge.
Why it matters
Readmission after elective gastrointestinal surgery has multiple reported causes, with ileus and organ/space infection prominent in this cohort. The association with pulmonary disorder also identifies a patient characteristic linked to readmission risk. These findings help describe where postdischarge complications arise and which factors may warrant attention when assessing readmission risk, while not establishing that any factor causes readmission.
What to keep in mind
The readmission analysis was observational, despite using patients enrolled in two randomized trials; associations therefore do not establish causation. The findings apply to elective gastroenterological surgery with clean-contaminated wounds.