One-year Unplanned Readmission After Colorectal Cancer Surgery in Western China

ABSTRACT

Purpose: Readmissions are common after colorectal cancer surgery. There are limited data related one-year unplanned readmission after colorectal cancer surgery. The aim of this study was to ascertain the incidence rate of unplanned readmission in Western China, identify causes and risk factors of one-year unplanned readmission (UR) in patients who underwent enhanced recovery pathways for colorectal cancer (CRC) surgery. Materials and Methods: A retrospective study using a CRC surgery database of patients treated in West China Hospital was performed. Patients who underwent enhanced recovery pathways for colorectal cancer surgery between January 2013 and May 2016 were investigated. The postoperative follow-up data were all routinely recorded for up to one year or more, the one-year unplanned readmission rate after initial discharge and major reasons for UR were recorded. Multivariate logistic regression analyses was used to identify risk factors of UR. Results: A total of 446 patients were included, with 18.6% of patients readmitted. In a multivariable analysis, preoperative comorbidity was associated with the largest risk of readmission (odds ratio, 2.91[95% CI, 1.32– 6.99]). The main reason of readmission within 30 days after discharge was wound bleeding or infection. While intestinal obstruction was the major cause for readmission after 3 months of discharge.

Conclusions: One-year unplanned readmission occurs frequently after CRC in Western China and is strongly associated with preoperative comorbidity. Attention should be paid to wound healing at the early stage of discharge, and bowel obstruction 3 months after discharge.

Keywords::

• colorectal surgery
• unplanned readmission
• risk factors
• fast track
• cancer
• fast track surgery

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

ACKNOWLEDGMENT

This research was supported by West China Hospital of Sichuan University.

AUTHOR CONTRIBUTIONS

Jie Yang, Jun Xiao, Jin-hua Feng and Ka Li contributed equally to this work; Jie Yang collected and analyzed the data, and drafted the manuscript; Jin-hua Feng provided analytical oversight; Ka Li designed, supervised the study and provided administrative support; Jun Xiao revised the manuscript for important intellectual content; all authors have read and approved the final version to be published.