Readmissions Within 48 Hours of Discharge: Reasons, Risk Factors, and Potential Improvements

Diseases of the Colon and Rectum
Fabian GrassDavid W Larson

Abstract

Hospital readmission rate is an important quality metric and has been recognized as a key measure of hospital value-based purchasing programs. This study aimed to assess the risk factors for hospital readmission with a focus on potentially preventable early readmissions within 48 hours of discharge. This is a retrospective cohort study. This study was conducted at a tertiary academic facility with a standardized enhanced recovery pathway. Consecutive patients undergoing elective major colorectal resections between 2011 and 2016 were included. Univariable and multivariable risk factors for overall and early (<48 hours) readmissions were identified. Specific surgical and medical reasons for readmission were compared between early and late readmissions. In total, 526 of 4204 patients (12.5%) were readmitted within 30 days of discharge. Independent risk factors were ASA score (≥3; OR, 1.5; 95% CI, 1.1-2), excess perioperative weight gain (OR, 1.7; 95% CI, 1.3-2.3), ileostomy (OR, 1.4; 95% CI, 1-2), and transfusion (OR, 2; 95% CI, 1.4-3), or reoperation (OR, 11.4; 95% CI, 7.4-17.5) during the index stay. No potentially preventable risk factor for early readmission (128 patients, 24.3% of all readmissions, 3% of total cohort) was ide...Continue Reading

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Citations

Oct 14, 2020·Langenbeck's Archives of Surgery·Fabio ButtiMartin Hübner
Apr 23, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Giacomo CaliniDavid W Larson
Jun 3, 2021·Healthcare·Jenna K Lovely, David W Larson
Sep 26, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Bolckmans RoelWolthuis Albert

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