title: Thirty-day readmissions after inpatient laparoscopic cholecystectomy: factors and outcomes.
abstract: BACKGROUND
  30-day readmissions are a considerable financial burden on medical institutions due to penalties faced from the Centers for Medicaid and Medicare.
  
  
  METHODS
  A retrospective review of 30-day readmissions was performed. The data were subdivided into medical severity-diagnostic related groups 417, 418, and 419, as categorized by the Centers for Medicaid and Medicare. Perioperative variables, diagnostic workup, operative interventions, and postoperative morbidity and outcomes were analyzed.
  
  
  RESULTS
  Forty-four (5.9%) readmissions were recorded, of 747 inpatient discharges. The data were further divided into DRGs 417, 418, and 419 with readmission rates of 13.6, 3.6%, and 5.4%, respectively. The highest rate of readmission was within the first 7 days. Etiology was divided into surgical (54.5%) and nonsurgical (45.4%).
  
  
  CONCLUSIONS
  Patients with major comorbidities had a higher rate of readmission (P < .05). In 45.4% of the readmissions, the cause was found to be nonsurgical. The surgical team was not consulted in 31.8% of the readmissions.
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, 16001 West 9 Mile Road, Southfield, MI 48075, USA. Electronic address: gurteshwar@gmail.com.
authors.forename: Gurteshwar
authors.initials: G
authors.lastname: Rana
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, 16001 West 9 Mile Road, Southfield, MI 48075, USA.
authors.forename: Jasneet Singh
authors.initials: JS
authors.lastname: Bhullar
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, 16001 West 9 Mile Road, Southfield, MI 48075, USA.
authors.forename: Gokulakkrishna
authors.initials: G
authors.lastname: Subhas
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, 16001 West 9 Mile Road, Southfield, MI 48075, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Kolachalam
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, 16001 West 9 Mile Road, Southfield, MI 48075, USA.
authors.forename: V K
authors.initials: VK
authors.lastname: Mittal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D015897:Comorbidity; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: 30-day readmissions; Inpatient; Laparoscopic cholecystectomy; Major comorbidities; Reducing readmission rate