Readmissions after ileostomy closure: cause to revisit a standardized enhanced recovery pathway?

Abstract Background Our objective was to evaluate ileostomy reversal patients managed with a standardized enhanced recovery pathway to identify factors associated with readmissions. Methods Prospective review database identified ileostomy reversal patients. Variables for the index admission and readmission were evaluated. Results Three hundred thirty-two patients were analyzed. The primary diagnosis was colorectal cancer (57.6%). Thirteen percent of the patients were discharged by postoperative day (POD) 1, 47% by POD 2, and 65% by POD 3. The complication rate was 16.8%. The main complication was ileus/small bowel obstruction ( n = 27). Thirty-day readmission rate was 12.4% ( n = 41); small bowel obstruction ( n = 27) was the most frequent readmission diagnosis. The median readmission POD was 7. Only 1 patient had a follow-up visit before readmission. The median readmission length of stay was 4 days. Conclusions Most ileostomy reversal readmissions occur before the first follow-up and stem from preventable causes. An enhanced recovery pathway modification may improve outcomes and utilization in this group.