title: Factors associated with 30-day hospital readmission after hysterectomy.
abstract: OBJECTIVE
  To analyze factors associated with 30-day readmission among women who underwent hysterectomy for uterine cancer and benign indications.
  
  
  METHODS
  We used the National Surgical Quality Improvement Project database to perform a cohort study of women who underwent hysterectomy from 2011 to 2012. Patients were stratified by surgical indication (uterine cancer or benign indications). Multivariable logistic regression models were constructed to determine factors associated with 30-day readmission. Model fit statistics were used to evaluate the importance of demographic factors, preoperative comorbidities, and postoperative complications on readmission.
  
  
  RESULTS
  The rate of 30-day readmission was 6.1% among 4,725 women with uterine cancer and 3.4% after hysterectomy for benign gynecologic disease in 36,471 patients. In a series of multivariable models, postoperative complications including wound complications, infections, and pulmonary emboli and myocardial infarctions were the factors most strongly associated with readmission. Compared with women without a complication, complications increased the readmission rate from 2.5 to 20.3% for women with uterine cancer and from 1.5 to 15.1% for those without cancer. Among women with uterine cancer, postoperative complications explained 34.3% of the variance in readmission compared with 5.9% for demographic factors and 2.2% for preoperative comorbidities. For patients with benign diseases, complications accounted for 32.1%, preoperative conditions 1.2%, and demographic factors 2.5% of the variance in readmission.
  
  
  CONCLUSIONS
  Efforts to reduce readmission should be directed at initiatives to reduce complications and improve the care of women who experience a complication.
authors.affiliation: Departments of Obstetrics and Gynecology and Medicine and the Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, the Department of Epidemiology, Mailman School of Public Health, Columbia University, and New York Presbyterian Hospital, New York, New York; and the Department of Obstetrics and Gynecology, University of California-Los Angeles, Los Angeles, California.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Dessources
authors.forename: June Y
authors.initials: JY
authors.lastname: Hou
authors.forename: Ana I
authors.initials: AI
authors.lastname: Tergas
authors.forename: William M
authors.initials: WM
authors.lastname: Burke
authors.forename: Cande V
authors.initials: CV
authors.lastname: Ananth
authors.forename: Eri
authors.initials: E
authors.lastname: Prendergast
authors.forename: Ling
authors.initials: L
authors.lastname: Chen
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Jason D
authors.initials: JD
authors.lastname: Wright
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology