Risk factors associated with unplanned readmission following excisional haemorrhoidectomy
Aim Excisional haemorrhoidectomy is the gold standard for management of advanced symptomatic haemorrhoids. Although an effective treatment, it is associated with significant postoperative morbidity with pain, bleeding and a high readmission rate. This study seeks to investigate potential risk factor...
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Veröffentlicht in: | Colorectal disease 2020-02, Vol.22 (2), p.187-194 |
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creator | Xia, W. MacFater, W. S. Barazanchi, A. W. H. Sammour, T. Hill, A. G. |
description | Aim
Excisional haemorrhoidectomy is the gold standard for management of advanced symptomatic haemorrhoids. Although an effective treatment, it is associated with significant postoperative morbidity with pain, bleeding and a high readmission rate. This study seeks to investigate potential risk factors that may predict unplanned 30‐day readmissions following excisional haemorrhoidectomy.
Method
A retrospective cohort review of all haemorrhoidectomies performed at Counties Manukau District Health Board, Auckland, New Zealand, between January 2012 and December 2017 was performed. Baseline demographic data, readmission data and potential variables for readmission were recorded. Univariate and multivariate logistic regression analyses were performed to determine significant variables for readmission within 30 days.
Results
In total, 485 cases of excisional haemorrhoidectomy were included in the final analysis with 62 (12.8%) unplanned readmissions. The demographics between the no readmission and unplanned readmission groups were similar. Multivariate logistic regression analysis demonstrated that male gender (P = 0.018) and the use of non‐diathermy devices (P = 0.017) were significant risk factors for readmission. Initial dispensing of opioid analgesia did not decrease the risk of readmission.
Conclusion
This study suggests that male gender and surgical technique are associated with increased risk of readmission. |
doi_str_mv | 10.1111/codi.14852 |
format | Article |
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Excisional haemorrhoidectomy is the gold standard for management of advanced symptomatic haemorrhoids. Although an effective treatment, it is associated with significant postoperative morbidity with pain, bleeding and a high readmission rate. This study seeks to investigate potential risk factors that may predict unplanned 30‐day readmissions following excisional haemorrhoidectomy.
Method
A retrospective cohort review of all haemorrhoidectomies performed at Counties Manukau District Health Board, Auckland, New Zealand, between January 2012 and December 2017 was performed. Baseline demographic data, readmission data and potential variables for readmission were recorded. Univariate and multivariate logistic regression analyses were performed to determine significant variables for readmission within 30 days.
Results
In total, 485 cases of excisional haemorrhoidectomy were included in the final analysis with 62 (12.8%) unplanned readmissions. The demographics between the no readmission and unplanned readmission groups were similar. Multivariate logistic regression analysis demonstrated that male gender (P = 0.018) and the use of non‐diathermy devices (P = 0.017) were significant risk factors for readmission. Initial dispensing of opioid analgesia did not decrease the risk of readmission.
Conclusion
This study suggests that male gender and surgical technique are associated with increased risk of readmission.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.14852</identifier><identifier>PMID: 31491051</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Analgesia ; Demography ; Female ; haemorrhoidectomy ; haemorrhoids ; Hemorrhoidectomy - adverse effects ; Hemorrhoids ; Hemorrhoids - surgery ; Humans ; Logistic Models ; Male ; Middle Aged ; Morbidity ; Opioids ; Pain perception ; Patient Readmission - statistics & numerical data ; Postoperative Complications - etiology ; readmissions ; Retrospective Studies ; Risk Factors ; Sex Factors ; Treatment Outcome</subject><ispartof>Colorectal disease, 2020-02, Vol.22 (2), p.187-194</ispartof><rights>Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland</rights><rights>Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland.</rights><rights>Copyright © 2020 The Association of Coloproctology of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3572-ebf2793f001a1665a17a2f47b6a6560d77afa849ad3ad5ae2b1d528ec83b91533</citedby><cites>FETCH-LOGICAL-c3572-ebf2793f001a1665a17a2f47b6a6560d77afa849ad3ad5ae2b1d528ec83b91533</cites><orcidid>0000-0002-4918-8871 ; 0000-0002-9323-7036 ; 0000-0003-0250-4942</orcidid></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.14852$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcodi.14852$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31491051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xia, W.</creatorcontrib><creatorcontrib>MacFater, W. S.</creatorcontrib><creatorcontrib>Barazanchi, A. W. H.</creatorcontrib><creatorcontrib>Sammour, T.</creatorcontrib><creatorcontrib>Hill, A. G.</creatorcontrib><title>Risk factors associated with unplanned readmission following excisional haemorrhoidectomy</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim
Excisional haemorrhoidectomy is the gold standard for management of advanced symptomatic haemorrhoids. Although an effective treatment, it is associated with significant postoperative morbidity with pain, bleeding and a high readmission rate. This study seeks to investigate potential risk factors that may predict unplanned 30‐day readmissions following excisional haemorrhoidectomy.
Method
A retrospective cohort review of all haemorrhoidectomies performed at Counties Manukau District Health Board, Auckland, New Zealand, between January 2012 and December 2017 was performed. Baseline demographic data, readmission data and potential variables for readmission were recorded. Univariate and multivariate logistic regression analyses were performed to determine significant variables for readmission within 30 days.
Results
In total, 485 cases of excisional haemorrhoidectomy were included in the final analysis with 62 (12.8%) unplanned readmissions. The demographics between the no readmission and unplanned readmission groups were similar. Multivariate logistic regression analysis demonstrated that male gender (P = 0.018) and the use of non‐diathermy devices (P = 0.017) were significant risk factors for readmission. Initial dispensing of opioid analgesia did not decrease the risk of readmission.
Conclusion
This study suggests that male gender and surgical technique are associated with increased risk of readmission.</description><subject>Adult</subject><subject>Analgesia</subject><subject>Demography</subject><subject>Female</subject><subject>haemorrhoidectomy</subject><subject>haemorrhoids</subject><subject>Hemorrhoidectomy - adverse effects</subject><subject>Hemorrhoids</subject><subject>Hemorrhoids - surgery</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Opioids</subject><subject>Pain perception</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Postoperative Complications - etiology</subject><subject>readmissions</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Treatment Outcome</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kF1LwzAUhoMobk5v_AFS8EaEzp6kSdtLmV-DwUD0wqty2qQus21msjL3780-9MILz01ODg8PLy8h5xANwc9NaaQeQpxyekD6EAsWAoP0cLvTMM0g6pET5-ZRBCKB9Jj0GMT-yqFP3p61-wgqLJfGugCdM6XGpZLBSi9nQdcuamxb_7UKZaOd06YNKlPXZqXb90B9lXpzwjqYoWqMtTOjpfKyZn1KjiqsnTrbvwPy-nD_MnoKJ9PH8eh2EpaMJzRURUWTjFU-HIIQHCFBWsVJIVBwEckkwQrTOEPJUHJUtADJaarKlBUZcMYG5GrnXVjz2Sm3zH3OUtU-uDKdyylNRRZzHsUevfyDzk1nfXpPMR5RKgRshNc7qrTGOauqfGF1g3adQ5RvCs83hefbwj18sVd2RaPkL_rTsAdgB6x0rdb_qPLR9G68k34Du_GL-g</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Xia, W.</creator><creator>MacFater, W. S.</creator><creator>Barazanchi, A. W. H.</creator><creator>Sammour, T.</creator><creator>Hill, A. G.</creator><general>Wiley Subscription Services, Inc</general><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>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4918-8871</orcidid><orcidid>https://orcid.org/0000-0002-9323-7036</orcidid><orcidid>https://orcid.org/0000-0003-0250-4942</orcidid></search><sort><creationdate>202002</creationdate><title>Risk factors associated with unplanned readmission following excisional haemorrhoidectomy</title><author>Xia, W. ; MacFater, W. S. ; Barazanchi, A. W. H. ; Sammour, T. ; Hill, A. G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3572-ebf2793f001a1665a17a2f47b6a6560d77afa849ad3ad5ae2b1d528ec83b91533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Analgesia</topic><topic>Demography</topic><topic>Female</topic><topic>haemorrhoidectomy</topic><topic>haemorrhoids</topic><topic>Hemorrhoidectomy - adverse effects</topic><topic>Hemorrhoids</topic><topic>Hemorrhoids - surgery</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Opioids</topic><topic>Pain perception</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Postoperative Complications - etiology</topic><topic>readmissions</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xia, W.</creatorcontrib><creatorcontrib>MacFater, W. S.</creatorcontrib><creatorcontrib>Barazanchi, A. W. H.</creatorcontrib><creatorcontrib>Sammour, T.</creatorcontrib><creatorcontrib>Hill, A. G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xia, W.</au><au>MacFater, W. S.</au><au>Barazanchi, A. W. H.</au><au>Sammour, T.</au><au>Hill, A. G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors associated with unplanned readmission following excisional haemorrhoidectomy</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2020-02</date><risdate>2020</risdate><volume>22</volume><issue>2</issue><spage>187</spage><epage>194</epage><pages>187-194</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim
Excisional haemorrhoidectomy is the gold standard for management of advanced symptomatic haemorrhoids. Although an effective treatment, it is associated with significant postoperative morbidity with pain, bleeding and a high readmission rate. This study seeks to investigate potential risk factors that may predict unplanned 30‐day readmissions following excisional haemorrhoidectomy.
Method
A retrospective cohort review of all haemorrhoidectomies performed at Counties Manukau District Health Board, Auckland, New Zealand, between January 2012 and December 2017 was performed. Baseline demographic data, readmission data and potential variables for readmission were recorded. Univariate and multivariate logistic regression analyses were performed to determine significant variables for readmission within 30 days.
Results
In total, 485 cases of excisional haemorrhoidectomy were included in the final analysis with 62 (12.8%) unplanned readmissions. The demographics between the no readmission and unplanned readmission groups were similar. Multivariate logistic regression analysis demonstrated that male gender (P = 0.018) and the use of non‐diathermy devices (P = 0.017) were significant risk factors for readmission. Initial dispensing of opioid analgesia did not decrease the risk of readmission.
Conclusion
This study suggests that male gender and surgical technique are associated with increased risk of readmission.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31491051</pmid><doi>10.1111/codi.14852</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4918-8871</orcidid><orcidid>https://orcid.org/0000-0002-9323-7036</orcidid><orcidid>https://orcid.org/0000-0003-0250-4942</orcidid></addata></record> |
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subjects | Adult Analgesia Demography Female haemorrhoidectomy haemorrhoids Hemorrhoidectomy - adverse effects Hemorrhoids Hemorrhoids - surgery Humans Logistic Models Male Middle Aged Morbidity Opioids Pain perception Patient Readmission - statistics & numerical data Postoperative Complications - etiology readmissions Retrospective Studies Risk Factors Sex Factors Treatment Outcome |
title | Risk factors associated with unplanned readmission following excisional haemorrhoidectomy |
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