Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery.
BACKGROUND
Initial programmes of fast-track open colonic surgery with a planned 2-day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast-track open colonic surgery programme with a planned hospital stay of 2 versus 3 days.


METHODS
The study included 541 consecutive colonic resections from one surgical department with a structured care programme, including well defined discharge criteria, between April 1997 and December 2005. The planned hospital stay was increased from 2 to 3 days from August 2004. All patients were examined 8 and 30 days after surgery.


RESULTS
Readmission rates fell from 20.1 per cent in 408 patients with a planned 2-day hospital stay (period 1) to 11.3 per cent in 133 patients with a planned 3-day hospital stay (period 2) (P < 0.020). Median length of primary hospital stay was 2 and 3 days, median stay after readmission was 5 and 5.5 days, and median (mean) total stay was 3 (5.6) and 3 (5.7) days in periods 1 and 2 respectively. The readmission rate in period 2 was lower because there were fewer readmissions for short-term observation or social reasons. There was no difference in type and incidence of morbidity between the two periods.


CONCLUSIONS
Readmission after fast-track open colonic resection was reduced by planning discharge 3 instead of 2 days after surgery, with the same discharge criteria.
Andersen
J
J
Department of Surgical Gastroenterology, Hvidovre University Hospital, Copenhagen, Denmark. j.and@dadlnet.dk
Hjort-Jakobsen
D
D
Christiansen
P S
PS
Kehlet
H
H
D000368:Aged; D003108:Colonic Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D010347:Patient Care Planning / Q000458:organization & administration* / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies