title: How often do patients return to the operating room after colorectal resections?
abstract: OBJECTIVE
  We sought to identify the rate of re-operation after an index colorectal surgical procedure and potential contributing risk factors.
  
  
  METHODS
  This is a retrospective cohort study from the American College of Surgeons National Surgical Quality Improvement Program. We identified all patients who either returned or did not return to the operating room after any colorectal resection from January 2005 to December 2008.
  
  
  RESULTS
  From a total cohort of 635, 265 patients included in the National Surgical Quality Improvement Program over the 4-year study period, we identified 54, 237 patients who underwent colorectal operations. A return to the operating room was coded in 5.4 ± 0.1% of non colorectal resection patients and 7.6 ± 0.2% of colorectal resection patients (P < 0.001). The multivariate model identified patients with postoperative diagnostic codes for abdominal cavity hernia or colostomy complication as having the highest odds of return to the operating room within 30 days. Patients returning to the operating room had longer length of stay and higher overall mortality compared with those patients who did not return to the operating room.
  
  
  CONCLUSIONS
  Return to the operating room is a relatively common occurrence after colorectal resections, with an associated high rate of mortality. Given the association between return to the operating room and adverse patient outcomes, emphasis should be placed on determining strategies to reduce the need for return to the operating room.
authors.affiliation: Department of Colorectal Surgery, Lahey Clinic, Burlington, MA, USA. rocco.ricciardi@lahey.org
authors.forename: R
authors.initials: R
authors.lastname: Ricciardi
authors.forename: P L
authors.initials: PL
authors.lastname: Roberts
authors.forename: T E
authors.initials: TE
authors.lastname: Read
authors.forename: P W
authors.initials: PW
authors.lastname: Marcello
authors.forename: J F
authors.initials: JF
authors.lastname: Hall
authors.forename: D J
authors.initials: DJ
authors.lastname: Schoetz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003082:Colectomy / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data; D003106:Colon / Q000601:surgery*; D003125:Colostomy / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D058996:Quality Improvement; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States; D055815:Young Adult