Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study
Objective:. To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery. Background:. Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-06-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000417 |
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| author | Michael H. McGillion, RN, PhD Flavia K. Borges, MD, PhD David Conen, MD, MPH Daniel I. Sessler, MD Brenda L. Coleman, RN, PhD Maura Marcucci, MD, MSc Carley Ouellette, RN, MSc Marissa Bird, RN, PhD Carly Whitmore, RN, PhD Shaunattonie Henry, RN, PhD Sandra Ofori, MD, MSc Shirley M. Pettit, RN Deborah M. Bedini, RN, MHS Leslie P. Gauthier, MScT Jennifer Lounsbury, RN(EC), MN Nancy M. Carter, RN, PhD Vikas Tandon, MD Ameen Patel, MD Teresa Cafaro, MD, MSc Marko R. Simunovic, MD John A. Harlock, MD Diane Heels-Ansdell, MSc Fadi Elias, MD, MS Theodore Rapanos, MD Shawn Forbes, MD Elizabeth Peter, RN, PhD Judy Watt-Watson, RN, PhD Kelly Metcalfe, RN, PhD Sandra L. Carroll, RN, PhD Philip J. Devereaux, MD, PhD |
| author_facet | Michael H. McGillion, RN, PhD Flavia K. Borges, MD, PhD David Conen, MD, MPH Daniel I. Sessler, MD Brenda L. Coleman, RN, PhD Maura Marcucci, MD, MSc Carley Ouellette, RN, MSc Marissa Bird, RN, PhD Carly Whitmore, RN, PhD Shaunattonie Henry, RN, PhD Sandra Ofori, MD, MSc Shirley M. Pettit, RN Deborah M. Bedini, RN, MHS Leslie P. Gauthier, MScT Jennifer Lounsbury, RN(EC), MN Nancy M. Carter, RN, PhD Vikas Tandon, MD Ameen Patel, MD Teresa Cafaro, MD, MSc Marko R. Simunovic, MD John A. Harlock, MD Diane Heels-Ansdell, MSc Fadi Elias, MD, MS Theodore Rapanos, MD Shawn Forbes, MD Elizabeth Peter, RN, PhD Judy Watt-Watson, RN, PhD Kelly Metcalfe, RN, PhD Sandra L. Carroll, RN, PhD Philip J. Devereaux, MD, PhD |
| author_sort | Michael H. McGillion, RN, PhD |
| collection | DOAJ |
| description | Objective:. To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery.
Background:. Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability.
Methods:. We undertook an international (28 centers, 14 countries) prospective cohort study of a representative sample of adults ≥45 years of age who underwent noncardiac surgery. Risk factors for readmission were assessed using Cox regression (ClinicalTrials.gov, NCT00512109).
Results:. Of 36,657 eligible participants, 2744 (7.5%; 95% confidence interval [CI], 7.2–7.8) were readmitted within 30 days of discharge. Rates of readmission were highest in the first 7 days after discharge and declined over the follow-up period. Multivariable analyses demonstrated that 9 baseline characteristics (eg, cancer treatment in past 6 months; adjusted hazard ratio [HR], 1.44; 95% CI, 1.30–1.59), 5 baseline laboratory and physical measures (eg, estimated glomerular filtration rate or on dialysis; HR, 1.47; 95% CI, 1.24–1.75), 7 surgery types (eg, general surgery; HR, 1.86; 95% CI, 1.61–2.16), 5 index hospitalization events (eg, stroke; HR, 2.21; 95% CI, 1.24–3.94), and 3 other factors (eg, discharge to nursing home; HR, 1.61; 95% CI, 1.33–1.95) were associated with readmission.
Conclusions:. Readmission following noncardiac surgery is common (1 in 13 patients). We identified perioperative risk factors associated with 30-day readmission that can help frontline clinicians identify which patients are at the highest risk of readmission and target them for preventive measures. |
| format | Article |
| id | doaj-art-5856fb4c94a9443f96f61e16f5da00b6 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-5856fb4c94a9443f96f61e16f5da00b62025-01-24T09:18:39ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-06-0152e41710.1097/AS9.0000000000000417202406000-00013Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort StudyMichael H. McGillion, RN, PhD0Flavia K. Borges, MD, PhD1David Conen, MD, MPH2Daniel I. Sessler, MD3Brenda L. Coleman, RN, PhD4Maura Marcucci, MD, MSc5Carley Ouellette, RN, MSc6Marissa Bird, RN, PhD7Carly Whitmore, RN, PhD8Shaunattonie Henry, RN, PhD9Sandra Ofori, MD, MSc10Shirley M. Pettit, RN11Deborah M. Bedini, RN, MHS12Leslie P. Gauthier, MScT13Jennifer Lounsbury, RN(EC), MN14Nancy M. Carter, RN, PhD15Vikas Tandon, MD16Ameen Patel, MD17Teresa Cafaro, MD, MSc18Marko R. Simunovic, MD19John A. Harlock, MD20Diane Heels-Ansdell, MSc21Fadi Elias, MD, MS22Theodore Rapanos, MD23Shawn Forbes, MD24Elizabeth Peter, RN, PhD25Judy Watt-Watson, RN, PhD26Kelly Metcalfe, RN, PhD27Sandra L. Carroll, RN, PhD28Philip J. Devereaux, MD, PhD29* From the School of Nursing, McMaster University, Hamilton, ON, Canada† Population Health Research Institute, Hamilton, ON, Canada† Population Health Research Institute, Hamilton, ON, Canada‖ Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH¶ Sinai Health System, Toronto, ON, Canada† Population Health Research Institute, Hamilton, ON, Canada* From the School of Nursing, McMaster University, Hamilton, ON, Canada* From the School of Nursing, McMaster University, Hamilton, ON, Canada* From the School of Nursing, McMaster University, Hamilton, ON, Canada* From the School of Nursing, McMaster University, Hamilton, ON, Canada† Population Health Research Institute, Hamilton, ON, Canada† Population Health Research Institute, Hamilton, ON, Canada** Hamilton Health Sciences, Hamilton General Hospital, Hamilton, ON, Canada†† Hamilton Health Sciences, Juravinski Hospital, Hamilton, ON, Canada* From the School of Nursing, McMaster University, Hamilton, ON, Canada* From the School of Nursing, McMaster University, Hamilton, ON, Canada‡ School of Medicine, McMaster University, Hamilton, ON, Canada‡ School of Medicine, McMaster University, Hamilton, ON, Canada† Population Health Research Institute, Hamilton, ON, Canada†† Hamilton Health Sciences, Juravinski Hospital, Hamilton, ON, Canada** Hamilton Health Sciences, Hamilton General Hospital, Hamilton, ON, Canada§ Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada‡‡ Department of Surgery, McMaster University, Hamilton, ON, Canada‡‡ Department of Surgery, McMaster University, Hamilton, ON, Canada†† Hamilton Health Sciences, Juravinski Hospital, Hamilton, ON, Canada§§ Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.§§ Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.§§ Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.* From the School of Nursing, McMaster University, Hamilton, ON, Canada† Population Health Research Institute, Hamilton, ON, CanadaObjective:. To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery. Background:. Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability. Methods:. We undertook an international (28 centers, 14 countries) prospective cohort study of a representative sample of adults ≥45 years of age who underwent noncardiac surgery. Risk factors for readmission were assessed using Cox regression (ClinicalTrials.gov, NCT00512109). Results:. Of 36,657 eligible participants, 2744 (7.5%; 95% confidence interval [CI], 7.2–7.8) were readmitted within 30 days of discharge. Rates of readmission were highest in the first 7 days after discharge and declined over the follow-up period. Multivariable analyses demonstrated that 9 baseline characteristics (eg, cancer treatment in past 6 months; adjusted hazard ratio [HR], 1.44; 95% CI, 1.30–1.59), 5 baseline laboratory and physical measures (eg, estimated glomerular filtration rate or on dialysis; HR, 1.47; 95% CI, 1.24–1.75), 7 surgery types (eg, general surgery; HR, 1.86; 95% CI, 1.61–2.16), 5 index hospitalization events (eg, stroke; HR, 2.21; 95% CI, 1.24–3.94), and 3 other factors (eg, discharge to nursing home; HR, 1.61; 95% CI, 1.33–1.95) were associated with readmission. Conclusions:. Readmission following noncardiac surgery is common (1 in 13 patients). We identified perioperative risk factors associated with 30-day readmission that can help frontline clinicians identify which patients are at the highest risk of readmission and target them for preventive measures.http://journals.lww.com/10.1097/AS9.0000000000000417 |
| spellingShingle | Michael H. McGillion, RN, PhD Flavia K. Borges, MD, PhD David Conen, MD, MPH Daniel I. Sessler, MD Brenda L. Coleman, RN, PhD Maura Marcucci, MD, MSc Carley Ouellette, RN, MSc Marissa Bird, RN, PhD Carly Whitmore, RN, PhD Shaunattonie Henry, RN, PhD Sandra Ofori, MD, MSc Shirley M. Pettit, RN Deborah M. Bedini, RN, MHS Leslie P. Gauthier, MScT Jennifer Lounsbury, RN(EC), MN Nancy M. Carter, RN, PhD Vikas Tandon, MD Ameen Patel, MD Teresa Cafaro, MD, MSc Marko R. Simunovic, MD John A. Harlock, MD Diane Heels-Ansdell, MSc Fadi Elias, MD, MS Theodore Rapanos, MD Shawn Forbes, MD Elizabeth Peter, RN, PhD Judy Watt-Watson, RN, PhD Kelly Metcalfe, RN, PhD Sandra L. Carroll, RN, PhD Philip J. Devereaux, MD, PhD Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study Annals of Surgery Open |
| title | Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study |
| title_full | Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study |
| title_fullStr | Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study |
| title_full_unstemmed | Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study |
| title_short | Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study |
| title_sort | risk factors for hospital readmission following noncardiac surgery international cohort study |
| url | http://journals.lww.com/10.1097/AS9.0000000000000417 |
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