title: Postdischarge complications are an important predictor of postoperative readmissions.
abstract: BACKGROUND
  Thirty-day readmissions are common in general surgery patients and affect long-term outcomes including mortality. We sought to determine the effect of complication timing on postoperative readmissions.
  
  
  METHODS
  Patients from our institutional American College of Surgeons National Surgical Quality Improvement Project database who underwent general surgery procedures from 2006 to 2011 were included. The primary outcome of interest was 30-day hospital readmission.
  
  
  RESULTS
  Patients diagnosed with postdischarge complications were significantly more likely to be readmitted (56%) compared with patients diagnosed with complications before discharge (7%, P < .001). Independent predictors of postdischarge complications included laparoscopic case, short hospital stay, preoperative dyspnea, and independent functional status. Gastrointestinal complications and surgical site infection were the most common reasons for readmission.
  
  
  CONCLUSIONS
  The development of complications after hospital discharge places patients at significant risk for readmission. Early identification and treatment of gastrointestinal complications and surgical site infections in the outpatient setting may decrease postoperative readmission rates.
authors.affiliation: Department of Surgery, University of Wisconsin, Madison, WI, USA. Electronic address: stevis@uwhealth.org.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Tevis
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Brittney M
authors.initials: BM
authors.lastname: Kohlnhofer
authors.affiliation: Department of Surgery, University of Wisconsin, Madison, WI, USA.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Weber
authors.affiliation: Department of Surgery, University of Wisconsin, Madison, WI, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kennedy
mesh_terms: D000368:Aged; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D010359:Patient Readmission / Q000639:trends*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011184:Postoperative Period; D011379:Prognosis; D058996:Quality Improvement; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative; D013997:Time Factors; D014922:Wisconsin / Q000453:epidemiology
keywords: Postdischarge complication; Postoperative readmission; Timing