Certain surgeries have far higher 30-day readmission risks, study shows

Some post-operative complications can spell big trouble for patients recovering from surgical procedures, especially abdominal surgery, according to a new study published in the September issue of the Journal of the American College of Surgeons.

The researchers compared ICD-9 data, patient demographics and comorbidities across a range of surgical procedures to analyze the risk factors associated with post-surgical readmissions.

The study examined 1,442 patients who had surgery between 2009 and 2011. About 11 percent of patients were readmitted within 30 days of surgery. Of the readmitted patients:

• Almost half had developed gastrointestinal complications or infections.
• Patients with sepsis or urinary tract infections (UTIs) were about five times more likely to be readmitted than patients without these complications.
• Among the highest-risk surgeries for post-operative complications were surgeries involving the pancreas, liver and colon.
• Postoperative wound infection and postoperative pulmonary complications increased readmission rates by 3 ½ times.
• For every additional post-operative complication a patient had, the re-hospitalization stay doubled.

The study highlighted the need for better prevention of complications, as well as keen attention to the post-operative transitions of care, noted John F. Sweeney, MD, FACS, chief, division of general and gastrointestinal surgery at Emory University School of Medicine, Atlanta, in the report.

“The biggest bang for the buck is going to be a combination of decrease of complications, and decrease of length-of-stay, resulting in decrease of readmissions,” Sweeney said in a press statement. “Decreasing complications will benefit the patient, the hospital, and the payer, and will improve quality of care.”

The surgical study was funded in part by a grant from the National Institutes of Health/National Institute on Aging.

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