Preventable Emergency Department Visits After Colorectal Surgery

Area of Science:

• Colorectal Surgery
• Emergency Medicine
• Quality Improvement

Background:

• Emergency departments (EDs) are crucial for postoperative care, yet ED visits are underrepresented in quality databases.
• Understanding the reasons for and patterns of postoperative ED visits in colorectal surgery is limited.
• Potentially preventable ED visits are key targets for improving surgical care quality.

Purpose of the Study:

• To characterize postoperative ED visits following colorectal surgery.
• To identify factors associated with these visits for targeted interventions.

Main Methods:

• Retrospective cohort study at an academic medical center.
• Included consecutive patients undergoing colectomy or proctectomy (2014-2018).
• Analyzed frequency, indications, and clinical/sociodemographic factors of ED visits within 30 days of discharge.

Main Results:

• 11% of 1763 patients had 207 ED visits within 30 days post-discharge; 2/3 resulted in readmission.
• Median time to presentation was 8 days; median ED time was 7.8 hours.
• One-third of visits were potentially preventable (pain: 17%, stoma complications: 13%). Non-English primary language increased risk for any (RR 2.7) and preventable (RR 3.6) visits.

Conclusions:

• A significant portion of ED visits after colorectal surgery are preventable.
• Pain and stoma complications are common reasons for potentially preventable visits.
• Patients with limited English proficiency require focused attention to reduce ED visit risk.