Complications after discharge predict readmission after colorectal surgery.

Surgical Endoscopy
Jeremy AlbrightScott E Regenbogen

Abstract

Health care providers, hospitals, and pay-for-performance programs are focused on strategies identifying patients at highest risk for re-admission after colorectal surgery. The study objective was to determine characteristics most associated with re-admission after elective colorectal surgery using a conceptual framework approach. This is an observational study of Michigan Surgical Quality Collaborative clinical registry data for 8962 colorectal surgery cases between July-2012 and April-2015. Separate mixed models were fit using known re-admission risk factors aligned in categories that may impact re-admissions by different mechanisms. Overall model discrimination was evaluated using Area Under the Curve estimated on a hold-out data set and examining differences in predicted versus observed re-admission across risk quintiles. The overall 30-day re-admission rate was 10.5%. From Model 1 to Model 6, discrimination of re-admission was poor until Model 6 (AUC, 0.56, 0.61, 0.65, 0.63, 0.72, 0.81). Differences for observed re-admission rates comparing 'very low' versus 'very high' risk strata from Model 1 to Model 6 were 6%, 11%, 15%, 14%, 20%, and 30% respectively, and all comparisons were significant (p < 0.01). Though there were s...Continue Reading

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Citations

Sep 25, 2020·Diseases of the Colon and Rectum·Susanna S HillKarim Alavi

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