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

Details

Serval ID
serval:BIB_8BE059424402
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Risk factors for 90-day readmission and return to the operating room following abdominal operations for Crohn's disease.
Journal
Surgery
Author(s)
Grass F., Ansell J., Petersen M., Mathis K.L., Lightner A.L.
ISSN
1532-7361 (Electronic)
ISSN-L
0039-6060
Publication state
Published
Issued date
12/2019
Peer-reviewed
Oui
Volume
166
Number
6
Pages
1068-1075
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
This study aimed to determine timing and risk factors for 30- and 90-day unplanned hospital readmissions and return to the operating room.
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.
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 <.001), and preoperative immunomodulator therapy (HR 2.70, P < .001).
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.
Pubmed
Web of science
Open Access
Yes
Create date
27/09/2019 8:05
Last modification date
28/10/2021 5:45
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