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Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study.
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.
Afiliação
  • McGillion MH; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Borges FK; Population Health Research Institute, Hamilton, ON, Canada.
  • Conen D; Population Health Research Institute, Hamilton, ON, Canada.
  • Sessler DI; School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Coleman BL; Population Health Research Institute, Hamilton, ON, Canada.
  • Marcucci M; School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Ouellette C; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Bird M; Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH.
  • Whitmore C; Sinai Health System, Toronto, ON, Canada.
  • Henry S; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Ofori S; Population Health Research Institute, Hamilton, ON, Canada.
  • Pettit SM; School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Bedini DM; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Gauthier LP; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Lounsbury J; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Carter NM; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Tandon V; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Patel A; Population Health Research Institute, Hamilton, ON, Canada.
  • Cafaro T; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Simunovic MR; Population Health Research Institute, Hamilton, ON, Canada.
  • Harlock JA; Hamilton Health Sciences, Hamilton General Hospital, Hamilton, ON, Canada.
  • Heels-Ansdell D; Hamilton Health Sciences, Juravinski Hospital, Hamilton, ON, Canada.
  • Elias F; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Rapanos T; Hamilton Health Sciences, Juravinski Hospital, Hamilton, ON, Canada.
  • Forbes S; From the School of Nursing, McMaster University, Hamilton, ON, Canada.
  • Peter E; School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Watt-Watson J; School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Metcalfe K; Hamilton Health Sciences, Juravinski Hospital, Hamilton, ON, Canada.
  • Carroll SL; Population Health Research Institute, Hamilton, ON, Canada.
  • Devereaux PJ; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Ann Surg Open ; 5(2): e417, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38911647
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Ann Surg Open Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Canadá
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Ann Surg Open Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Canadá