دورية أكاديمية
Timing of readmissions for complications following emergency colectomy: follow-up beyond post-operative day 30 matters.
| العنوان: | Timing of readmissions for complications following emergency colectomy: follow-up beyond post-operative day 30 matters. |
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| المؤلفون: | Caminsky NG; Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC, Canada., Moon J; Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC, Canada., Marinescu D; Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC, Canada., Pang AJ; Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC, Canada., Vasilevsky CA; Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC, Canada., Boutros M; Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC, Canada. boutrom3@ccf.org.; Department of Colorectal Surgery, Cleveland Clinic Florida (Weston Hospital), Weston, FL, USA. boutrom3@ccf.org. |
| المصدر: | Surgical endoscopy [Surg Endosc] 2024 Apr; Vol. 38 (4), pp. 2240-2251. Date of Electronic Publication: 2024 Mar 19. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1992- : New York : Springer Original Publication: [Berlin] : Springer International, c1987- |
| مواضيع طبية MeSH: | Postoperative Complications*/epidemiology , Postoperative Complications*/etiology , Postoperative Complications*/surgery , Patient Readmission*, Adult ; Humans ; Female ; Retrospective Studies ; Follow-Up Studies ; Risk Factors ; Colectomy/adverse effects ; Colectomy/methods |
| مستخلص: | Background and Purpose: Emergency colectomies are associated with a higher risk of complications compared to elective ones. A critical assessment of complications occurring beyond post-operative day 30 (POD30) is lacking. This study aimed to assess the readmission rate and factors associated with readmission 6-months following emergency colectomy. Methods: A retrospective cohort study of adult patients who underwent emergency colectomy (2010-2018) was performed using the Nationwide Readmissions Database. The cohort was divided into two groups: (i) no readmission and (ii) emergency readmission(s) for complications related to colectomy (defined using ICD-9/10 codes). Readmissions were categorized as either "early" (POD0-30) or "late" (> POD30). Differences between groups were described and multivariable regression controlling for relevant covariates defined a priori were used to identify factors associated with timing of readmission and cost. Results: Of 141,481 eligible cases, 13.22% (n = 18,699) were readmitted within 6-months of emergency colectomy for colectomy-related complications, 61.63% of which were "late" readmissions (> POD30). The most common reasons for "late" readmission were for bleeding, gastrointestinal, and infectious complications (20.80%, 25.30%, and 32.75%, respectively). On multiple logistic regression, female gender (OR 1.12; 95%CI 1.04-1.21), open procedures (OR 1.12, 95%CI 1.011-1.24), and sigmoidectomies (OR 1.51, 95%CI 1.39-1.65, relative to right hemicolectomies) were the strongest predictors of "late" readmission. On multiple linear regression, "late" readmissions were associated with a $1717.09 USD (95%CI $1717.05-$1717.12) increased cost compared to "early" readmissions. Discussion: The majority of colectomy-related readmissions following emergency colectomy occur beyond POD30 and are associated with cases that are of overall higher morbidity, as well as open sigmoidectomies. Given the associated increased cost of care, mitigation of such readmissions by close follow-up prior to and beyond POD30 is advisable. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Complications; Emergency colectomy; Late readmission |
| تواريخ الأحداث: | Date Created: 20240320 Date Completed: 20240401 Latest Revision: 20240520 |
| رمز التحديث: | 20240521 |
| مُعرف محوري في PubMed: | PMC10978660 |
| DOI: | 10.1007/s00464-024-10724-y |
| PMID: | 38503906 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1432-2218 |
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| DOI: | 10.1007/s00464-024-10724-y |