Digestive Diseases and Sciences

, Volume 60, Issue 1, pp 47–53

Factors Related to Readmission After Major Elective Surgery

  • Gregory C. Wilson
  • R. Cutler QuillinIII
  • Jeffrey M. Sutton
  • Koffi Wima
  • Joshua J. Shaw
  • Richard S. Hoehn
  • Ian M. Paquette
  • Daniel E. Abbott
  • Shimul A. Shah
Original Article

DOI: 10.1007/s10620-014-3306-0

Cite this article as:
Wilson, G.C., Cutler Quillin, R., Sutton, J.M. et al. Dig Dis Sci (2015) 60: 47. doi:10.1007/s10620-014-3306-0

Abstract

Background

Hospital readmissions have received increased scrutiny as a marker for excessive resource utilization and also quality care.

Aim

To identify the rate of and risk factors for hospital readmission after major surgery at academic medical centers.

Methods

Using the University Health Consortium Clinical Database, 30-day readmission rates in all adult patients undergoing colectomy (n = 103,129), lung resection (n = 73,558), gastric bypass (n = 62,010) or abdominal aortic surgery (n = 17,997) from 2009 to 2012 were identified. Logistic regression was performed to examine risks for readmission.

Results

Overall readmission rates ranged from 8.9 % after gastric bypass to 15.8 % after colectomy. Black race was associated with increased likelihood for readmission after three of the four procedures with odds ratios ranging from 1.13 after colectomy to 1.44 after gastric bypass. For all procedures, moderate, severe, or extreme severity of illness (SOI) and need for transitional care were associated with increased odds for hospital readmission. Lower center volume was an independent predictor of readmission after gastric bypass surgery and aortic surgery.

Conclusion

Readmission rates after major elective surgery are high across national academic centers. Center volume, SOI, and need for transitional care after discharge are factors associated with readmission and may be used to identify patients at high risk of readmission and hospital utilization after major surgery.

Keywords

ReadmissionTransitional careElective surgeryRaceSeverity of illness

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Gregory C. Wilson
    • 1
  • R. Cutler QuillinIII
    • 1
  • Jeffrey M. Sutton
    • 1
  • Koffi Wima
    • 1
  • Joshua J. Shaw
    • 1
  • Richard S. Hoehn
    • 1
  • Ian M. Paquette
    • 1
  • Daniel E. Abbott
    • 1
  • Shimul A. Shah
    • 1
  1. 1.Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Division of Transplant Surgery, Department of SurgeryUniversity of Cincinnati College of MedicineCincinnatiUSA