Contributors to Increased Mortality Associated With Care Fragmentation After Emergency General Surgery.

JAMA Surgery
Marta L McCrumBenjamin S Brooke

Abstract

Care fragmentation at time of readmission after emergency general surgery (EGS) is associated with high mortality; however, the factors underlying this finding remain unclear. To identify patient and hospital factors associated with increased mortality among patients after EGS readmitted within 30 days of discharge to a nonindex hospital. Retrospective cohort study using the 2014 Healthcare Cost and Utilization Project Nationwide Readmissions Database. Participants were all adult patients (18 years or older) who underwent 1 of the 15 most common EGS procedures in the United States from January 1 to November 30, 2014, and survived to discharge. The dates of analysis were October through December 2019. Thirty-day readmission to a hospital other than that of the index surgical procedure. The study examined the association of interventions during readmission, change in hospital resource level, and severity of patient illness during readmission. Ninety-day inpatient mortality. In total, 71 944 patients who underwent EGS (mean [SD] age, 59.0 [18.3] years; 53.5% [38 487 of 71 944] female) were readmitted within 30 days of discharge, of whom 10 495 (14.6%) were readmitted to a nonindex hospital. Compared with patients readmitted to ind...Continue Reading

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Citations

Mar 29, 2021·The Journal of Pediatrics·Nelangi M PintoRichard Nelson
Jul 6, 2021·The Journal of Trauma and Acute Care Surgery·Eva M UrrechagaRishi Rattan

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