title: Factors related to readmission after major elective surgery.
abstract: BACKGROUND
  Hospital readmissions have received increased scrutiny as a marker for excessive resource utilization and also quality care.
  
  
  OBJECTIVE
  To identify the rate of and risk factors for hospital readmission after major surgery at academic medical centers.
  
  
  METHODS
  Using the University Health Consortium Clinical Database, 30-day readmission rates in all adult patients undergoing colectomy (n = 103,129), lung resection (n = 73,558), gastric bypass (n = 62,010) or abdominal aortic surgery (n = 17,997) from 2009 to 2012 were identified. Logistic regression was performed to examine risks for readmission.
  
  
  RESULTS
  Overall readmission rates ranged from 8.9 % after gastric bypass to 15.8 % after colectomy. Black race was associated with increased likelihood for readmission after three of the four procedures with odds ratios ranging from 1.13 after colectomy to 1.44 after gastric bypass. For all procedures, moderate, severe, or extreme severity of illness (SOI) and need for transitional care were associated with increased odds for hospital readmission. Lower center volume was an independent predictor of readmission after gastric bypass surgery and aortic surgery.
  
  
  CONCLUSIONS
  Readmission rates after major elective surgery are high across national academic centers. Center volume, SOI, and need for transitional care after discharge are factors associated with readmission and may be used to identify patients at high risk of readmission and hospital utilization after major surgery.
authors: Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Division of Transplant Surgery, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0558, MSB 2006C, Cincinnati, OH, 45267-0558, USA.
authors: Gregory C
authors: GC
authors: Wilson
authors: R
authors: R
authors: Cutler Quillin
authors: Jeffrey M
authors: JM
authors: Sutton
authors: Koffi
authors: K
authors: Wima
authors: Joshua J
authors: JJ
authors: Shaw
authors: Richard S
authors: RS
authors: Hoehn
authors: Ian M
authors: IM
authors: Paquette
authors: Daniel E
authors: DE
authors: Abbott
authors: Shimul A
authors: SA
authors: Shah
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000601:surgery; D003082:Colectomy; D017558:Elective Surgical Procedures; D015390:Gastric Bypass; D006801:Humans; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014656:Vascular Surgical Procedures