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Determining the Association Between Unplanned Reoperation and Readmission in Selected General Surgery Operations.

Florence E Turrentine1, Mark E Smolkin2, Timothy L McMurry2

  • 1Department of Surgery, University of Virginia, Charlottesville, Virginia; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia.

The Journal of Surgical Research
|June 27, 2021
PubMed
Summary

Unplanned reoperations significantly increase the risk of unplanned readmissions in general surgery patients undergoing abdominal procedures. This highlights the need to consider reoperation in discharge and follow-up planning to reduce readmissions.

Keywords:
ACS NSQIPReadmissionReoperationSurgical outcomes

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Area of Science:

  • General Surgery
  • Surgical Outcomes
  • Patient Safety

Background:

  • Unplanned reoperations and readmissions are critical factors impacting patient morbidity and mortality.
  • Limited research exists on the association between reoperation and readmission in general surgery.
  • This study investigates the relationship between reoperation and readmission in specific abdominal operations.

Purpose of the Study:

  • To examine the association between unplanned reoperations and unplanned readmissions.
  • To identify risk factors for unplanned readmissions following selected abdominal surgeries.
  • To inform discharge and follow-up planning to mitigate readmission rates.

Main Methods:

  • Utilized data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2014-2018.
  • Included six groups of abdominal operations: ventral hernia repair, colectomy, appendectomy, proctectomy, small bowel resection, and gastrectomy.
  • Analyzed patients discharged within 14 days, defining unplanned reoperations as those during the index hospitalization and unplanned readmissions within 14 days of discharge.

Main Results:

  • Over 787,000 patients were included, with ventral hernia repair, colectomy, and appendectomy being the most common procedures.
  • Unplanned reoperation was independently associated with unplanned readmission across multiple procedures, including ventral hernia repair (OR 2.84), colectomy (OR 1.58), appendectomy (OR 2.91), and proctectomy (OR 1.41).
  • Other significant factors associated with readmission included functional status, American Society of Anesthesiologists (ASA) classification (especially ASA 4/5), age, and sex.

Conclusions:

  • Unplanned reoperations are a significant predictor of unplanned readmissions after selected abdominal operations.
  • Considering reoperation status in discharge and follow-up planning is crucial for reducing unplanned readmissions.
  • These findings underscore the importance of comprehensive post-operative care strategies.