Readmissions after colorectal surgery cannot be predicted

INTRODUCTION: Readmission after discharge from the hospital is an undesirab le outcome. In an attempt to prevent unplanned readmissions after abdominal or perineal colon resection, we proposed to identify risk factors associat ed with return to the hospital. METHODS: Study participants consisted of 24 9 patients who were operated on from July 1, 1996, to March 30, 1998. All p atients who were readmitted within 90 days of discharge from the hospital a fter surgery were evaluated for the study. A retrospective review of charts was performed to assess whether readmission within 90 days was a direct co nsequence of the recent operation (unplanned related readmission). These pa tients were compared with a control group consisting of patients who were n ever readmitted or who were readmitted with an unrelated problem. RESULTS: Of the 249 patients, 59 (24 percent) were readmitted within 90 days of disc harge from the:hospital. Twenty-two (9 percent) were unplanned related read missions. Ten patients were readmitted with unrelated emergencies, and 27 p atients were readmitted electively. II the unplanned related group, there w as no correlation between age, gender, admission diagnosis, activity status , or postoperative length of stay and the likelihood of readmission. Patien ts with multiple chronic medical problems or those who developed postoperat ive complications did not have a higher readmission rate. Patients with ulc erative colitis or those who underwent abdominoperineal resection or total/ subtotal colectomy had a higher incidence of readmissions, although the dif ference was not significant. The mean interval between discharge from the h ospital and readmission with a related complication was 19 days. Small-bowe l obstruction was the most common reason for readmission, and all cases res olved with conservative management. Mean length of stay during all readmiss ions was 8 days. CONCLUSION: The incidence of unplanned related readmission s 30 days after abdominal or perineal colon resection is 9 percent, and the se readmissions could not be predicted from the postoperative course. Becau se 82 percent of unplanned readmissions occurred within 30 days, this time frame is suitable for computerized comparative analysis.