Related Experiment Videos
Predictors and outcome of readmission after laparoscopic intestinal surgery
David Patrick O'Brien1, Anthony Senagore, James Merlino
1Division of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA. obriendd@uc.edu
Insights
Ten percent of patients readmitted after major intestinal surgery had inflammatory bowel disease or pulmonary issues. Identifying these risk factors can improve patient care and reduce unexpected readmissions following laparoscopic colon and rectal operations.
Area of Science:
- Colorectal surgery
- Surgical outcomes
- Patient safety
Context:
- Identifying predictors of early readmission after major intestinal operations remains a challenge.
- Laparoscopic colon and rectal operations are increasingly common procedures.
Purpose:
- To determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations.
Summary:
- A study of 787 patients undergoing laparoscopic colon and rectal operations found a 10% readmission rate within 30 days.
- Common readmission causes included bowel obstruction, ileus, and intra-abdominal abscess.
- Inflammatory bowel disease and pulmonary comorbidities were identified as independent risk factors for readmission.
Impact:
- Findings may enable selective changes in perioperative care or discharge criteria to reduce unexpected readmissions.
- Improved patient selection and risk stratification can optimize outcomes after colorectal surgery.
Background:
Previous studies have failed to identify predictors of early readmission after major intestinal operations. The objectives of this study were to determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations.
Methods:
Patients readmitted (PR) to the hospital within 30 days of discharge after laparoscopic colon and rectal operations were identified from a prospectively maintained database. The PR group was compared with patients that were not readmitted (NR). Outcomes and variables related to readmission were evaluated.
Results:
There were 820 consecutive elective laparoscopic colon and rectal operations performed over a 5-year period, with adequate follow-up data for 787 cases. Seventy-nine (10%) patients were readmitted. There was no difference in the age, sex, surgeon, or type of operation between the PR and NR groups. The most common causes for readmission were bowel obstruction (19%), ileus (18%), intra-abdominal abscess (14%), and anastomotic leak (9%). Overall mean (median) length of stay (LOS) for the index admission was 3.7 +/- 4.3 (3.0) days. Patients in the PR group had a trend toward a longer index admission LOS than the NR group (5.4 +/- 8.8 [3.0] versus 3.5 +/- 3.3 [3.0], p = 0.068). Univariate analysis demonstrated that patients with inflammatory bowel disease, pulmonary comorbidities, and steroid use were more likely to be readmitted. Multivariate analysis confirmed that inflammatory bowel disease and pulmonary comorbidity are independent risk factors for readmission.
Conclusions:
Early readmission after laparoscopic colon and rectal operations is not associated with early discharge. Identification of specific patient characteristics indicating risk for early readmission may allow for selective changes in perioperative care or discharge criteria to avoid unexpected readmission. An erratum to this article can be found at
Related Concept Videos
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Intestinal Obstruction II: Pathophysiology