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Risk Factors for Delayed (>30 Days) Readmission Following Rectal Cancer Surgery
Danish Ali1, Maria Syed2, Adriana C Gamboa3
1Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
The Journal of Surgical Research
|January 24, 2025
Summary
Delayed readmissions after rectal cancer surgery are common, with surgical site infections being a primary cause. Higher American Society of Anesthesiologists scores increase risk, while pelvic drains may reduce it.
Area of Science:
- Oncology
- Surgical Outcomes
- Healthcare Quality
Background:
- Unplanned, delayed readmissions (>30 days) post-oncologic surgery increase mortality and healthcare costs.
- Limited literature exists on delayed readmissions specifically following rectal cancer surgery.
- Identifying risk factors for delayed readmissions is crucial for improving patient outcomes and hospital quality metrics.
Purpose of the Study:
- To assess risk factors associated with delayed (>30 days) readmissions after rectal cancer surgery.
- To identify common causes of delayed readmissions in this patient population.
- To inform targeted interventions for reducing readmission rates and improving care.
Main Methods:
- A case-control study utilizing the US Rectal Cancer Consortium database.
- Inclusion criteria: adult patients who underwent surgery and subsequent readmission.
- Multivariable logistic regression and descriptive statistics were employed to analyze risk factors and causes of readmission.
Main Results:
- Out of 1417 patients, 403 (28.4%) experienced readmission, with 101 (25.1%) classified as delayed.
- Higher American Society of Anesthesiologists-Physical Status score (>II) was linked to increased delayed readmission risk (OR=1.81).
- Intraoperative pelvic drain placement was associated with reduced delayed readmission risk (OR=0.57).
- Surgical site infection was the leading cause for both delayed (18.4%) and early (27.4%) readmissions.
Conclusions:
- The risk of readmission after rectal cancer surgery extends beyond 30 days, with a significant proportion occurring later.
- Surgical site infection remains the primary driver for both early and delayed readmissions.
- Reinforcing infection prevention strategies is essential to mitigate readmission rates in rectal cancer patients.
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