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Emergency Sx Patients Often Readmitted to Different Hospital

Nearly 17 percent of readmitted patients ended up in hospital other than where they had surgery

THURSDAY, Nov. 12, 2015 (HealthDay News) — Nearly 17 percent of patients are readmitted to a hospital after having emergency surgery, with one in five of these patients admitted to a hospital other than where the surgery was done, according to a study published online Nov. 11 in JAMA Surgery.

The investigators examined data from 177,511 patients, aged 18 and older, who had emergency general surgery in California between 2007 and 2011. The most common procedures were laparoscopic appendix removal (35.2 percent) and gallbladder removal (19.3 percent). Overall, 5.91 percent of the patients were readmitted to the hospital within 30 days after their emergency surgery.

Readmission rates ranged from 4.1 percent among those who had upper gastrointestinal surgery to 16.8 percent among those who had cardiothoracic surgery. Of the readmitted patients, 16.8 percent were admitted to a different hospital. The most common reasons for readmission were surgical site infections (16.9 percent), gastrointestinal complications (11.3 percent), and pulmonary complications (3.6 percent). Patients with a higher risk of readmission included those with other health problems, those who were discharged from hospital against medical advice, and those with public health insurance.

“While local programs can be instituted to prevent complications and readmissions, the incorporation of electronic health records and the creation of large health systems will facilitate better care for the 15 to 20 percent of patients who are readmitted to a different hospital,” O. Joe Hines, M.D., from the David Geffen School of Medicine at the University of California, Los Angeles, writes in an accompanying editorial. “All of the components are in place to make meaningful progress in surgery, and with our leadership, we can realize substantial change and, most importantly, happy, healthy patients.”

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