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Table 4 Studies of preventable readmissions related to surgical procedures among adults, United States, 2000-2009

From: Determinants of preventable readmissions in the United States: a systematic review

Citation

Reported readmission type (and explanation if provided)

Index condition*

Readmit condition

Timeframe

Population and Setting

Design and Sample size

Data source(s)

Risk factors/associated factors

Conceptually linked admissions†

Strategy for patient linkage‡

Used multivariate statistics§

Azimuddin et al [24]

Unplanned

Abdominal or perineal colon resection surgery

Related to the primary surgical procedure

90 days

Colorectal surgery patients from single PA hospital

Retrospective cohort

(249)

Chart review

No statistically significant factors found

Yes

No

No

Kiran et al [33]

Unexpected early

Intestinal operations

Any condition (excluding planned)

30 days

Colorectal surgery service patients

single OH hospital

Retrospective cohort

(553)

Chart review, Interviews

Encounter

Increasing length of stay

No

Yes

No

Medress and Fleshner [36]

Unplanned related

(a direct consequence of the recent operation)

Ileal pouch-anal anastomosis surgery

Admission resulted from a complication

30 days

Inflammatory bowel disease patients requiring colectomy from single CA hospital

Retrospective cohort

(202)

Hospital databases, Interviews

No statistically significant factors found

Yes

Yes

No

O'Brien [37]

Early

Elective laparoscopic colon and rectal surgery

Any condition

30 days

Colorectal surgery patients from single OH hospital

Retrospective cohort

(820)

Hospital databases

Patient

Pulmonary disease

Inflammatory bowel disease

Encounter

Perioperative steroids

Conversion from laparoscopic to open operation

No

Yes

No

Ozturk et al [38]

Early

Ileal pouch-anal anastomosis surgery

Any emergent or elective, unplanned readmission

30 days

Ileal pouch-anal anastomosis surgery patients from single OH hospital

Retrospective cohort

(3,410)

Hospital database, Interviews

Patient

Comorbidity

Encounter

Laparoscopic approach

Synchronous protocolectomy

Postoperative blood transfusion

No

Yes

Yes

Reddy et al [40]

Early

Pancreatic resection

Any condition

30 days and 1 year

Pancreatic cancer patients, ≥66 years in SEER and Medicare Parts A and B nationwide

Retrospective cohort

(1,730)

SEER-Medicare Linked Data

Patient

Increasing Charlson score (1 year)

Encounter

Increasing length of stay (30 day and 1 year)

Distal pancreatectomy (30 day)

No

Yes

Yes

Scott et al [42]

Readmissions due to early infection

Surgery

Infection

14 to 28 days

Received prophylactic antibiotic prior to surgery from single NY hospital

Retrospective cohort

(9,016)

Hospital databases

Encounter

Skin or tissue biopsy

Dialysis shunt

Endarterectomy

Non-cardiac vascular repair

Early infection

Yes

No

Yes

Weller et al [43]

Short-term

Any surgical procedure

Venous thrombo-embolism (AHRQ PSI)

30 days

Surgical patients from NY

Retrospective cohort

(4,906)

New York Statewide Planning and Research

Cooperative System

Patient

Female**

White non-Hispanic**

Increasing age**

Yes

Yes

No

  1. * All exclusion criteria or specific diagnostic codes not reported - see original article for additional details.
  2. ** Study did not compare readmissions with non-readmissions so factors are from descriptive statistics/reports only
  3. † Explicitly specified a biological, theoretical or conceptual model linking the readmission condition to the index condition (includes readmissions for same condition)
  4. ‡ Specified a strategy or research design to guard against loss to follow up
  5. § Used multivariate statistics
  6. AHRQ = Agency for Healthcare Research and Quality
  7. SEER = Surveillance, Epidemiology and End Results
  8. PSI = Patient safety indicators