Open AccessPredictors and Outcome of Readmission after Laparoscopic Intestinal Surgery
Author(s) -
O’Brien David Patrick,
Senagore Anthony,
Merlino James,
Brady Karen,
Delaney Conor
Publication year - 2007
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-007-9345-3
Subject(s) - medicine , abdominal surgery , ileus , colorectal surgery , vascular surgery , cardiothoracic surgery , surgery , laparoscopy , cardiac surgery , general surgery , laparoscopic surgery , anastomosis
Erratum to: World J Surg DOI 10.1007/s00268‐007‐9236‐7 The original version of this article, published online on September 25, 2007 and in print in the November 2007 issue (vol 31/no 11, pp 2138–2143), did not include the full list of authors’ names. The correct list of authors and their affiliations are shown below. The article is reprinted in its entirety. Abstract Background Previous studies have failed to identify predictors of early readmission after major intestinal operations. The objectives of this study were to determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations. Methods Patients readmitted (PR) to the hospital within 30 days of discharge after laparoscopic colon and rectal operations were identified from a prospectively maintained database. The PR group was compared with patients that were not readmitted (NR). Outcomes and variables related to readmission were evaluated. Results There were 820 consecutive elective laparoscopic colon and rectal operations performed over a 5‐year period, with adequate follow‐up data for 787 cases. Seventy‐nine (10%) patients were readmitted. There was no difference in the age, sex, surgeon, or type of operation between the PR and NR groups. The most common causes for readmission were bowel obstruction (19%), ileus (18%), intra‐abdominal abscess (14%), and anastomotic leak (9%). Overall mean (median) length of stay (LOS) for the index admission was 3.7 ± 4.3 (3.0) days. Patients in the PR group had a trend toward a longer index admission LOS than the NR group (5.4 ± 8.8 [3.0] versus 3.5 ± 3.3 [3.0], p = 0.068). Univariate analysis demonstrated that patients with inflammatory bowel disease, pulmonary comorbidities, and steroid use were more likely to be readmitted. Multivariate analysis confirmed that inflammatory bowel disease and pulmonary comorbidity are independent risk factors for readmission. Conclusions Early readmission after laparoscopic colon and rectal operations is not associated with early discharge. Identification of specific patient characteristics indicating risk for early readmission may allow for selective changes in perioperative care or discharge criteria to avoid unexpected readmission.