V. Pandit1, F. S. Jehan1, C. Martinez1, M. Khan1, M. Zeeshan1, V. N. Nfonsam1 1University Of Arizona,Division Of Colorectal Surgery,Tucson, AZ, USA
Introduction: The recent era has seen a change of focus from simple mortality and complications to the quality of healthcare delivery. Hospital readmission within 30 days of an index hospitalization is recognized as a marker of poor-quality patient care. The aim of our study was to identify the patient related factors associated with 30-day readmission after colon surgery.
Methods: We performed a four year (2012-2015) analysis of the National Surgical Quality improvement program (NSQIP) and included all adult patients who underwent colon surgery for colon cancer. Outcome measures were to identify factors related factors associated with 30-day readmission after discharge. We performed regression analysis to control for confounding variables.
Results: A total of 95,055 patients were analyzed of which 36,279 patients had colon surgery for colon cancer and were included in our analysis. Mean age was 65+13 years, 51% were males and 72% were white. Overall mortality was 2.7% and 16% patients developed one or more complications. The 30-day readmission rate was 10%. On regression analysis, after controlling for confounders, age (OR: 1.4; 95%CI [1.2-2.1], p=0.03), presence of comorbidity (DM, HTN) (OR: 3.2; 95%CI [1.9-4.5], p=0.02), BMI > 30 kg/m2 (OR: 2.1; 95%CI [1.6-4.5], p=0.02), post-operative complication (OR: 5.5; 95%CI [3.2-8.9], p=0.01) and OR time (OR: 1.4; 95%CI [1.2-2.2], p=0.04) were independent predictors of 30-day readmission.
Conclusion: Risk factors for readmission after colon surgery are multifactorial; however, pre-surgery comorbidities and postoperative complications appear to drive readmissions in colon surgery for colon cancer. Identifying patients at risk of readmission and optimization and decreasing postoperative complications will decrease the risk of postoperative readmissions.