학술논문
Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study
Document Type
Academic Journal
Author
McGillion, Michael H.; 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 R.; Harlock, John A.; Heels-Ansdell, Diane; Elias, Fadi; Rapanos, Theodore; Forbes, Shawn; Peter, Elizabeth; Watt-Watson, Judy; Metcalfe, Kelly; Carroll, Sandra L.; Devereaux, Philip J.
Source
Annals of Surgery. Jun 01, 2024 5(2):e417-e417
Subject
Language
English
ISSN
2691-3593
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.