Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme
Aim Hospital readmission within 30 days of surgery has become a marker of poor quality patient care. This study aimed to investigate factors predictive of 30‐day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery after surgery (ERAS) programme. Method Consecutive pa...
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| Veröffentlicht in: | Colorectal disease 2015-07, Vol.17 (7), p.O148-O154 |
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| creator | Francis, N. K. Mason, J. Salib, E. Allanby, L. Messenger, D. Allison, A. S. Smart, N. J. Ockrim, J. B. |
| description | Aim
Hospital readmission within 30 days of surgery has become a marker of poor quality patient care. This study aimed to investigate factors predictive of 30‐day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery after surgery (ERAS) programme.
Method
Consecutive patients undergoing laparoscopic surgery for colorectal cancer within an ERAS programme between 2002 and 2009 were included. Data were collected relating to patient demographics, neoadjuvant chemoradiotherapy, ERAS compliance, and operative and postoperative outcomes. A logistic regression model was used to identify factors associated with readmissions after adjusting for the potential effect of covariables simultaneously.
Results
In all, 268 cancer patients underwent laparoscopic colorectal surgery (108 rectal resections), of whom 34 (12.7%) were readmitted due most commonly to bowel obstruction (29%) and surgical site infection (18%). The use of neoadjuvant therapy (odds ratio 4.49, 95% CI 1.41–14.35; P = 0.011) and ERAS compliance above 93% (odds ratio 0.38, 95% CI 0.18–0.84; P = 0.016) were independent predictors of readmission.
Conclusion
Poor ERAS compliance and preoperative chemoradiotherapy were significant predictors of readmission following laparoscopic colorectal cancer surgery. Further research is required to expand the scope of ERAS beyond hospital discharge. |
| doi_str_mv | 10.1111/codi.13002 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1690652079</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1690652079</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3672-6aadd1a16bde0fa3356cd7767bb124893ae933d8088e866b0435aa4d08ab43193</originalsourceid><addsrcrecordid>eNp9kE9P3DAQxS1UxL_2wgdAPlaVAnacOM6x2nYXBBRVourRmtiziyGJUzsL7LfHYYFj5-KR3u89ax4hx5yd8jRnxlt3ygVj-Q454IUUGRdcfXrd80zVnO2TwxjvGeOy4mqP7OdlrZRg4oA8z8GMPkQ6BLTOjK5fUcEyCxsaEGznYnS-p7AcMdAWBgg-Gj84Q41vfUAzQksN9CbJcR1WGDb0yY13Lnl6iv3dJNmUZfzjpA3BrwJ0HX4mu0toI355e4_In_nP29l5dnWzuJh9v8qMkFWeSQBrOXDZWGRLEKKUxlaVrJqG54WqBWAthFVMKVRSNqwQJUBhmYKmELwWR-TrNjf9_G-NcdTpJoNtCz36ddRc1kyWOasm9NsWNenIGHCph-A6CBvNmZ6a1lPT-rXpBJ-85a6bDu0H-l5tAvgWeHItbv4TpWc3Py7eQ7Otx8URnz88EB60rERV6r-_Fvr35e18oa65ZuIF9VmZ0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1690652079</pqid></control><display><type>article</type><title>Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Francis, N. K. ; Mason, J. ; Salib, E. ; Allanby, L. ; Messenger, D. ; Allison, A. S. ; Smart, N. J. ; Ockrim, J. B.</creator><creatorcontrib>Francis, N. K. ; Mason, J. ; Salib, E. ; Allanby, L. ; Messenger, D. ; Allison, A. S. ; Smart, N. J. ; Ockrim, J. B.</creatorcontrib><description>Aim
Hospital readmission within 30 days of surgery has become a marker of poor quality patient care. This study aimed to investigate factors predictive of 30‐day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery after surgery (ERAS) programme.
Method
Consecutive patients undergoing laparoscopic surgery for colorectal cancer within an ERAS programme between 2002 and 2009 were included. Data were collected relating to patient demographics, neoadjuvant chemoradiotherapy, ERAS compliance, and operative and postoperative outcomes. A logistic regression model was used to identify factors associated with readmissions after adjusting for the potential effect of covariables simultaneously.
Results
In all, 268 cancer patients underwent laparoscopic colorectal surgery (108 rectal resections), of whom 34 (12.7%) were readmitted due most commonly to bowel obstruction (29%) and surgical site infection (18%). The use of neoadjuvant therapy (odds ratio 4.49, 95% CI 1.41–14.35; P = 0.011) and ERAS compliance above 93% (odds ratio 0.38, 95% CI 0.18–0.84; P = 0.016) were independent predictors of readmission.
Conclusion
Poor ERAS compliance and preoperative chemoradiotherapy were significant predictors of readmission following laparoscopic colorectal cancer surgery. Further research is required to expand the scope of ERAS beyond hospital discharge.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.13002</identifier><identifier>PMID: 25988303</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aftercare - standards ; Aftercare - statistics & numerical data ; Aged ; Aged, 80 and over ; Colectomy - adverse effects ; Colectomy - methods ; Colectomy - rehabilitation ; colorectal ; Colorectal Neoplasms - surgery ; Colorectal Neoplasms - therapy ; enhanced recovery ; Female ; Humans ; Intestinal Obstruction - epidemiology ; Intestinal Obstruction - etiology ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Laparoscopy - rehabilitation ; Logistic Models ; Male ; Middle Aged ; Neoadjuvant Therapy - adverse effects ; Neoadjuvant Therapy - utilization ; Patient Compliance ; Patient Readmission - statistics & numerical data ; prediction ; readmission ; Risk Factors ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - etiology ; Time Factors</subject><ispartof>Colorectal disease, 2015-07, Vol.17 (7), p.O148-O154</ispartof><rights>Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland</rights><rights>Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3672-6aadd1a16bde0fa3356cd7767bb124893ae933d8088e866b0435aa4d08ab43193</citedby><cites>FETCH-LOGICAL-c3672-6aadd1a16bde0fa3356cd7767bb124893ae933d8088e866b0435aa4d08ab43193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcodi.13002$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcodi.13002$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25988303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Francis, N. K.</creatorcontrib><creatorcontrib>Mason, J.</creatorcontrib><creatorcontrib>Salib, E.</creatorcontrib><creatorcontrib>Allanby, L.</creatorcontrib><creatorcontrib>Messenger, D.</creatorcontrib><creatorcontrib>Allison, A. S.</creatorcontrib><creatorcontrib>Smart, N. J.</creatorcontrib><creatorcontrib>Ockrim, J. B.</creatorcontrib><title>Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim
Hospital readmission within 30 days of surgery has become a marker of poor quality patient care. This study aimed to investigate factors predictive of 30‐day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery after surgery (ERAS) programme.
Method
Consecutive patients undergoing laparoscopic surgery for colorectal cancer within an ERAS programme between 2002 and 2009 were included. Data were collected relating to patient demographics, neoadjuvant chemoradiotherapy, ERAS compliance, and operative and postoperative outcomes. A logistic regression model was used to identify factors associated with readmissions after adjusting for the potential effect of covariables simultaneously.
Results
In all, 268 cancer patients underwent laparoscopic colorectal surgery (108 rectal resections), of whom 34 (12.7%) were readmitted due most commonly to bowel obstruction (29%) and surgical site infection (18%). The use of neoadjuvant therapy (odds ratio 4.49, 95% CI 1.41–14.35; P = 0.011) and ERAS compliance above 93% (odds ratio 0.38, 95% CI 0.18–0.84; P = 0.016) were independent predictors of readmission.
Conclusion
Poor ERAS compliance and preoperative chemoradiotherapy were significant predictors of readmission following laparoscopic colorectal cancer surgery. Further research is required to expand the scope of ERAS beyond hospital discharge.</description><subject>Adult</subject><subject>Aftercare - standards</subject><subject>Aftercare - statistics & numerical data</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colectomy - adverse effects</subject><subject>Colectomy - methods</subject><subject>Colectomy - rehabilitation</subject><subject>colorectal</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Colorectal Neoplasms - therapy</subject><subject>enhanced recovery</subject><subject>Female</subject><subject>Humans</subject><subject>Intestinal Obstruction - epidemiology</subject><subject>Intestinal Obstruction - etiology</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Laparoscopy - rehabilitation</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - adverse effects</subject><subject>Neoadjuvant Therapy - utilization</subject><subject>Patient Compliance</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>prediction</subject><subject>readmission</subject><subject>Risk Factors</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - etiology</subject><subject>Time Factors</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9P3DAQxS1UxL_2wgdAPlaVAnacOM6x2nYXBBRVourRmtiziyGJUzsL7LfHYYFj5-KR3u89ax4hx5yd8jRnxlt3ygVj-Q454IUUGRdcfXrd80zVnO2TwxjvGeOy4mqP7OdlrZRg4oA8z8GMPkQ6BLTOjK5fUcEyCxsaEGznYnS-p7AcMdAWBgg-Gj84Q41vfUAzQksN9CbJcR1WGDb0yY13Lnl6iv3dJNmUZfzjpA3BrwJ0HX4mu0toI355e4_In_nP29l5dnWzuJh9v8qMkFWeSQBrOXDZWGRLEKKUxlaVrJqG54WqBWAthFVMKVRSNqwQJUBhmYKmELwWR-TrNjf9_G-NcdTpJoNtCz36ddRc1kyWOasm9NsWNenIGHCph-A6CBvNmZ6a1lPT-rXpBJ-85a6bDu0H-l5tAvgWeHItbv4TpWc3Py7eQ7Otx8URnz88EB60rERV6r-_Fvr35e18oa65ZuIF9VmZ0w</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Francis, N. K.</creator><creator>Mason, J.</creator><creator>Salib, E.</creator><creator>Allanby, L.</creator><creator>Messenger, D.</creator><creator>Allison, A. S.</creator><creator>Smart, N. J.</creator><creator>Ockrim, J. B.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201507</creationdate><title>Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme</title><author>Francis, N. K. ; Mason, J. ; Salib, E. ; Allanby, L. ; Messenger, D. ; Allison, A. S. ; Smart, N. J. ; Ockrim, J. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3672-6aadd1a16bde0fa3356cd7767bb124893ae933d8088e866b0435aa4d08ab43193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aftercare - standards</topic><topic>Aftercare - statistics & numerical data</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colectomy - adverse effects</topic><topic>Colectomy - methods</topic><topic>Colectomy - rehabilitation</topic><topic>colorectal</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Colorectal Neoplasms - therapy</topic><topic>enhanced recovery</topic><topic>Female</topic><topic>Humans</topic><topic>Intestinal Obstruction - epidemiology</topic><topic>Intestinal Obstruction - etiology</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Laparoscopy - rehabilitation</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - adverse effects</topic><topic>Neoadjuvant Therapy - utilization</topic><topic>Patient Compliance</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>prediction</topic><topic>readmission</topic><topic>Risk Factors</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - etiology</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Francis, N. K.</creatorcontrib><creatorcontrib>Mason, J.</creatorcontrib><creatorcontrib>Salib, E.</creatorcontrib><creatorcontrib>Allanby, L.</creatorcontrib><creatorcontrib>Messenger, D.</creatorcontrib><creatorcontrib>Allison, A. S.</creatorcontrib><creatorcontrib>Smart, N. J.</creatorcontrib><creatorcontrib>Ockrim, J. B.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Francis, N. K.</au><au>Mason, J.</au><au>Salib, E.</au><au>Allanby, L.</au><au>Messenger, D.</au><au>Allison, A. S.</au><au>Smart, N. J.</au><au>Ockrim, J. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2015-07</date><risdate>2015</risdate><volume>17</volume><issue>7</issue><spage>O148</spage><epage>O154</epage><pages>O148-O154</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim
Hospital readmission within 30 days of surgery has become a marker of poor quality patient care. This study aimed to investigate factors predictive of 30‐day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery after surgery (ERAS) programme.
Method
Consecutive patients undergoing laparoscopic surgery for colorectal cancer within an ERAS programme between 2002 and 2009 were included. Data were collected relating to patient demographics, neoadjuvant chemoradiotherapy, ERAS compliance, and operative and postoperative outcomes. A logistic regression model was used to identify factors associated with readmissions after adjusting for the potential effect of covariables simultaneously.
Results
In all, 268 cancer patients underwent laparoscopic colorectal surgery (108 rectal resections), of whom 34 (12.7%) were readmitted due most commonly to bowel obstruction (29%) and surgical site infection (18%). The use of neoadjuvant therapy (odds ratio 4.49, 95% CI 1.41–14.35; P = 0.011) and ERAS compliance above 93% (odds ratio 0.38, 95% CI 0.18–0.84; P = 0.016) were independent predictors of readmission.
Conclusion
Poor ERAS compliance and preoperative chemoradiotherapy were significant predictors of readmission following laparoscopic colorectal cancer surgery. Further research is required to expand the scope of ERAS beyond hospital discharge.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25988303</pmid><doi>10.1111/codi.13002</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aftercare - standards Aftercare - statistics & numerical data Aged Aged, 80 and over Colectomy - adverse effects Colectomy - methods Colectomy - rehabilitation colorectal Colorectal Neoplasms - surgery Colorectal Neoplasms - therapy enhanced recovery Female Humans Intestinal Obstruction - epidemiology Intestinal Obstruction - etiology Laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Laparoscopy - rehabilitation Logistic Models Male Middle Aged Neoadjuvant Therapy - adverse effects Neoadjuvant Therapy - utilization Patient Compliance Patient Readmission - statistics & numerical data prediction readmission Risk Factors Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Time Factors |
| title | Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme |
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