Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study Journal Articles uri icon

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abstract

  • Objective: To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery. Background: Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability. Methods: We undertook an international (28 centers, 14 countries) prospective cohort study of a representative sample of adults ≥45 years of age who underwent noncardiac surgery. Risk factors for readmission were assessed using Cox regression (ClinicalTrials.gov, NCT00512109). Results: Of 36,657 eligible participants, 2744 (7.5%; 95% confidence interval [CI], 7.2–7.8) were readmitted within 30 days of discharge. Rates of readmission were highest in the first 7 days after discharge and declined over the follow-up period. Multivariable analyses demonstrated that 9 baseline characteristics (eg, cancer treatment in past 6 months; adjusted hazard ratio [HR], 1.44; 95% CI, 1.30–1.59), 5 baseline laboratory and physical measures (eg, estimated glomerular filtration rate or on dialysis; HR, 1.47; 95% CI, 1.24–1.75), 7 surgery types (eg, general surgery; HR, 1.86; 95% CI, 1.61–2.16), 5 index hospitalization events (eg, stroke; HR, 2.21; 95% CI, 1.24–3.94), and 3 other factors (eg, discharge to nursing home; HR, 1.61; 95% CI, 1.33–1.95) were associated with readmission. Conclusions: Readmission following noncardiac surgery is common (1 in 13 patients). We identified perioperative risk factors associated with 30-day readmission that can help frontline clinicians identify which patients are at the highest risk of readmission and target them for preventive measures.

authors

  • McGillion, Michael
  • Borges, Flavia K
  • Conen, David
  • Sessler, Daniel I
  • Coleman, Brenda L
  • Marcucci, Maura
  • Ouellette, Carley
  • Bird, Marissa
  • Whitmore, Carly
  • Henry, Shaunattonie
  • Ofori, Sandra
  • Pettit, Shirley M
  • Bedini, Deborah M
  • Gauthier, Leslie P
  • Lounsbury, Jennifer
  • Carter, Nancy M
  • Tandon, Vikas
  • Patel, Ameen
  • Cafaro, Teresa
  • Simunovic, Marko
  • Harlock, John A
  • Heels-Ansdell, Diane
  • Elias, Fadi
  • Rapanos, Theodore
  • Forbes, Shawn
  • Peter, Elizabeth
  • Watt-Watson, Judy
  • Metcalfe, Kelly
  • Carroll, Sandra L
  • Devereaux, Philip

publication date

  • June 2024