title: What Factors Predict Hospital Readmission after Colorectal Surgery?
abstract: Readmissions pose a significant hardship for patients and constitute a major quality and financial concern for hospitals. We sought to define risk factors associated with hospital readmission after colorectal surgery at a tertiary care hospital. We evaluated readmission among all patients who underwent a colorectal surgical procedure between July 16, 2007 and June 30, 2011. In a cohort of 4879 operative encounters, 492 (10%) were readmitted to the hospital within 30 days of discharge. Procedures with highest readmissions included stoma creation (22%), ileoanal pouch surgery (22%), and total proctocolectomy (30%). In multivariate analysis, the following variables were associated with risk of readmission: postoperative complication, use of anxiolytics, high comorbidity score, patient setting, alcohol use, and stoma creation. Surgeon of record was not associated with readmission. In conclusion, several patient, procedural, and postoperative factors were associated with an increased risk of readmission. Considerably high rates of readmission were noted after stoma creation, ileoanal pouch procedures, and proctocolectomy. Surgeon of record was not associated with risk of readmission, indicating little value to this metric as a physician-specific indicator of quality.
authors.affiliation: Lahey Hospital & Medical Center, Burlington, Massachusetts, USA.
authors.forename: Basem
authors.initials: B
authors.lastname: Almussallam
authors.forename: Maurice
authors.initials: M
authors.lastname: Joyce
authors.forename: Peter W
authors.initials: PW
authors.lastname: Marcello
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Roberts
authors.forename: Todd D
authors.initials: TD
authors.lastname: Francone
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Read
authors.forename: Jason F
authors.initials: JF
authors.lastname: Hall
authors.forename: David J
authors.initials: DJ
authors.lastname: Schoetz
authors.forename: Rocco
authors.initials: R
authors.lastname: Ricciardi
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003107:Colorectal Surgery / Q000009:adverse effects* / Q000379:methods*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D011237:Predictive Value of Tests; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D062606:Tertiary Care Centers; D055815:Young Adult