Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme

2.50
Hdl Handle:
http://hdl.handle.net/11287/594025
Title:
Factors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programme
Authors:
Francis, N. K.; Mason, J.; Salib, E.; Allanby, L.; Messenger, D.; Allison, A. S.; Smart, Neil J. ( 0000-0002-3043-8324 ) ; Ockrim, J. B.
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.
Citation:
Colorectal Dis. 2015 Jul;17(7):O148-54.
Publisher:
Wiley
Journal:
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
Issue Date:
1-Jul-2015
URI:
http://hdl.handle.net/11287/594025
DOI:
10.1111/codi.13002
PubMed ID:
25988303
Additional Links:
http://dx.doi.org/10.1111/codi.13002
Type:
Journal Article
Language:
eng
ISSN:
1463-1318
Appears in Collections:
2015 RD&E publications; HeSRU publications

Full metadata record

DC FieldValue Language
dc.contributor.authorFrancis, N. K.en
dc.contributor.authorMason, J.en
dc.contributor.authorSalib, E.en
dc.contributor.authorAllanby, L.en
dc.contributor.authorMessenger, D.en
dc.contributor.authorAllison, A. S.en
dc.contributor.authorSmart, Neil J.en
dc.contributor.authorOckrim, J. B.en
dc.date.accessioned2016-01-19T12:38:45Zen
dc.date.available2016-01-19T12:38:45Zen
dc.date.issued2015-07-01en
dc.identifier.citationColorectal Dis. 2015 Jul;17(7):O148-54.en
dc.identifier.issn1463-1318en
dc.identifier.pmid25988303en
dc.identifier.doi10.1111/codi.13002en
dc.identifier.urihttp://hdl.handle.net/11287/594025en
dc.description.abstractAIM: 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.en
dc.language.isoengen
dc.publisherWileyen
dc.relation.urlhttp://dx.doi.org/10.1111/codi.13002en
dc.titleFactors predicting 30-day readmission after laparoscopic colorectal cancer surgery within an enhanced recovery programmeen
dc.typeJournal Articleen
dc.identifier.journalColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Irelanden
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