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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

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Evaluation of the Rothman Index in Predicting Readmission after Colorectal Resection.

Kent J Peterson¹, Carly M O'Donnell¹, Daniel C Eastwood²

¹Division of Colon and Rectal Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality

|November 1, 2023

Summary

The Rothman Index (RI) can predict 30-day readmission risk in gastrointestinal surgery patients. Higher last RI scores at discharge indicate a greater risk of readmission after colectomy or proctectomy.

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Area of Science:

Gastrointestinal Surgery
Health Informatics
Predictive Analytics

Background:

The Rothman Index (RI) is a validated real-time health indicator score.
RI has been used to assess readmission risk across various medical fields.
Its utility in gastrointestinal surgery remains unexplored.

Purpose of the Study:

To investigate the association between RI scores and 30-day readmission rates.
To evaluate RI's predictive capability in patients undergoing unplanned colectomy or proctectomy.
To determine if RI can aid in identifying high-risk surgical patients.

Main Methods:

Retrospective single-institution study of 427 inpatients.
Collected patient demographics and perioperative data, including RI metrics (last, lowest, trend).
Multivariate regression analyses were performed to assess the association between RI and readmission.

Main Results:

12.4% of patients experienced 30-day readmission.
Last RI, lowest RI, and RI score trends (increasing/decreasing) were significant predictors of readmission.
The last RI score at discharge showed the strongest association with readmission risk.

Conclusions:

The Rothman Index is a significant predictor of 30-day readmission after colorectal resection.
Last RI score at discharge is a key indicator for identifying at-risk patients.
RI shows promise as a tool for inpatient management to reduce readmissions.