Risk factors of unplanned readmission after colorectal surgery: a prospective, multicenter study.
OBJECTIVE
Unplanned readmission after colorectal surgery is a relatively frequent event, knowledge of which often is inaccurate. This study was designed to examine the incidence and causes of readmissions and to determine the criteria that could predict them.


METHODS
From June to September 2002, 1,421 patients were enrolled in a prospective, multicenter study performed by the Association Francaise de Chirurgie. The goal of the study was to determine mortality and morbidity after colorectal surgery for elective or emergency surgical management of diverticular disease or cancer. In the study, readmissions within three months after discharge were assessed.


RESULTS
Of 1,421 patients, 342 patients (27 percent) were readmitted once after a mean period of 53 days. Among the readmissions, 248 (19.5 percent) were planned and 94 (7.5 percent) were unplanned (mainly for septic complications). With the multivariate logistic regression analysis, five independent factors were significantly associated with a higher risk of unplanned readmission (in order of importance): surgical field contamination, long duration of operation, need for an associated surgical procedure, hemoglobin level <12 g/dl, and absence of air testing after colorectal anastomosis.


CONCLUSIONS
The study permitted to individualize several factors significantly associated with a higher risk of unplanned readmission after colorectal surgery.
Department of Digestive Surgery, University Hospital, Besancon, France.
D
D
Guinier
G A
GA
Mantion
A
A
Alves
F
F
Kwiatkowski
K
K
Slim
Y
Y
Panis
D000368:Aged; D003082:Colectomy; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D012044:Regression Analysis; D015996:Survival Rate