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Risk factors for 90-day readmission and return to the operating room following abdominal operations for Crohn’s disease

Published on Sep 1, 2019in Surgery3.48
· DOI :10.1016/j.surg.2019.08.006
Fabian Grass1
Estimated H-index: 1
(UNIL: University of Lausanne),
J. Ansell (Mayo Clinic)+ 2 AuthorsAmy L. Lightner (Cleveland Clinic)
Abstract
Abstract Background This study aimed to determine timing and risk factors for 30- and 90-day unplanned hospital readmissions and return to the operating room. Methods Retrospective case series, including consecutive adult patients with Crohn’s disease, undergoing a major abdominal surgical procedure during a 3.5-year inclusion period was performed. The primary outcomes were 0- to 30-day and 30- to 90-day readmission and return to the operating room rates. Univariate and multivariable risk factors for both outcomes at 30 and 90 days were assessed through Cox regression analysis. Results Of 680 included patients with Crohn’s disease, 89 (13.1%) were readmitted within 30 days, 55 (8.1%) within 30–90 days, and 11 (1.6%) in both follow-up periods for a combined 90-day readmission rate of 24.4% (n = 166). Multivariable risk factors for 30-day readmissions were type of procedure performed, corticosteroid use (hazard ratio [HR] 1.71, P = .01), younger age (HR 0.98 per year, P = .01), and prolonged disease duration (HR 1.03 per year, P = .03). No significant risk factors identified for 30- to 90-day readmissions. By 90 days, 76 patients (11.2%) had a return to the operating room (of which 8.8% was within 30 days). Risk factors for 30-day return to the operating room included tobacco use (HR 1.86, P = .04), diabetes (HR 3.30, P = .01), corticosteroid use (HR 3.51, P Conclusion Type of surgery, corticosteroid use, younger age, and prolonged disease duration were associated with 30-day hospital readmission, and tobacco use, diabetes, corticosteroid use, and preoperative immunomodulator therapy were risk factors for 30-day return to the operating room. Postoperative biologic therapy did not increase hospital readmission or return to operating room rates within 90 days of surgery.
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#1Chang Sik Yu (UOU: University of Ulsan)H-Index: 31
#2Sung Woo Jung (UOU: University of Ulsan)H-Index: 1
Last.Jin-Cheon Kim (UOU: University of Ulsan)H-Index: 31
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