Adhesion-related hospital readmissions after abdominal and pelvic surgery:a retrospective cohort study

Background Adhesions after abdominal and pelvic surgery are important compl ications, although their basic epidemiology is unclear. We investigated the frequency of such complications in the general population to provide a bas is for the targeting and assessment of new adhesion-prevention measures. Methods We used validated data from the Scottish National Health Service me dical record linkage database to identify patients undergoing open abdomina l or pelvic surgery in 1986, who had no record of such surgery in the prece ding 5 years; Patients were followed up for 10 years and subsequent readmis sions were:reviewed and outcomes classified by the degree of adhesion. We a lso assessed the rate of adhesion-related admissions in 1994 for the popula tion of 5 million people. Findings 1209 (5.7%) of all readmissions (21 347) were classified as being directly related to adhesions, with 1169 (3.8%) managed operatively. Overal l, 34.6% of the 29 790 patients who underwent open abdominal or pelvic surg ery in 1986 were readmitted a mean of 2.1 times over 10 years for a disorde r directly or possibly related to adhesions, or for abdominal or pelvic sur gery that could be potentially complicated by adhesions. 22.1% of all outco me readmissions occurred in the first year after initial:surgery, but readm issions continued steadily throughout the 10-year period. In 1994, 4199 adm issions were directly related to adhesions. Interpretation Postoperative adhesions have important consequences to patie nts, surgeons, and the health system. Surgical procedures with a high risk of adhesion-related complications need to be identified and adhesion preven tion carefully assessed.