Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population
Abstract Introduction Urgent hospital readmissions within 30 days of discharge after surgery are a measure of the quality of health and social care. This study aims to identify the characteristics of patients at higher risk of readmission and the main reasons for readmission, stratified by type of s...
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| Format: | Article |
| Language: | English |
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BMC
2025-07-01
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| Series: | Patient Safety in Surgery |
| Online Access: | https://doi.org/10.1186/s13037-025-00442-2 |
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| author | Gino Sartor Marco Fusco Marzio Milana Leonardo Rigon Giorgio Arcara Pierfranco Conte Alessandra Buja |
| author_facet | Gino Sartor Marco Fusco Marzio Milana Leonardo Rigon Giorgio Arcara Pierfranco Conte Alessandra Buja |
| author_sort | Gino Sartor |
| collection | DOAJ |
| description | Abstract Introduction Urgent hospital readmissions within 30 days of discharge after surgery are a measure of the quality of health and social care. This study aims to identify the characteristics of patients at higher risk of readmission and the main reasons for readmission, stratified by type of surgery. Methods This cross-sectional study analysed the medical records of patients over 60 years of age in 2022 who had undergone surgery. Records came from hospitals covering an area of 890,000 inhabitants in Northern Italy (ULSS Marca Trevigiana). Risk factors for readmission included demographic characteristics, hospitalisation details, comorbidities, and procedures. Readmission rates and 95% CI were calculated by risk factor, type of intervention and reason for readmission. A logistic model was used to estimate the OR of readmission, adjusting for potential confounders. Results The overall 30-day readmission rate was 3.8% (3.5–4.3), with the highest rates after gastrointestinal surgery (49.7 per 1,000 admissions) and the lowest after skin-soft tissue surgeries (15.5 per 1,000 admissions). Multivariate analysis identified dementia (OR = 3.19), end-stage kidney disease or dialysis (OR = 2.84), and metastatic cancer (OR = 2.65) as strong predictors of readmission. Advanced age (75+), male gender, primary cancer, and anemia were also independent predictors. Infection was the main reason for readmission. Other significant causes were hemorrhage, thrombosis/embolism, and intestinal obstruction. Conclusions The study highlights the importance of identifying risk factors for readmission to improve transitions of care. Targeted interventions for high-risk populations, particularly those with dementia, renal disease, or cancer, are essential to improve postoperative outcomes and alleviate the burden of unplanned readmissions on healthcare systems. |
| format | Article |
| id | doaj-art-6991b047e055448c8be20e9ed859cdb0 |
| institution | Kabale University |
| issn | 1754-9493 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Patient Safety in Surgery |
| spelling | doaj-art-6991b047e055448c8be20e9ed859cdb02025-08-20T03:45:36ZengBMCPatient Safety in Surgery1754-94932025-07-0119111110.1186/s13037-025-00442-2Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly populationGino Sartor0Marco Fusco1Marzio Milana2Leonardo Rigon3Giorgio Arcara4Pierfranco Conte5Alessandra Buja6Distretto Sociosanitario, Health Authority ULSS 2 Marca TrevigianaMedical Direction, Health Authority ULSS 2 Marca TrevigianaMedical Direction, Health Authority ULSS 2 Marca TrevigianaIRCCS San Camillo HospitalIRCCS San Camillo HospitalIRCCS San Camillo HospitalDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of PaduaAbstract Introduction Urgent hospital readmissions within 30 days of discharge after surgery are a measure of the quality of health and social care. This study aims to identify the characteristics of patients at higher risk of readmission and the main reasons for readmission, stratified by type of surgery. Methods This cross-sectional study analysed the medical records of patients over 60 years of age in 2022 who had undergone surgery. Records came from hospitals covering an area of 890,000 inhabitants in Northern Italy (ULSS Marca Trevigiana). Risk factors for readmission included demographic characteristics, hospitalisation details, comorbidities, and procedures. Readmission rates and 95% CI were calculated by risk factor, type of intervention and reason for readmission. A logistic model was used to estimate the OR of readmission, adjusting for potential confounders. Results The overall 30-day readmission rate was 3.8% (3.5–4.3), with the highest rates after gastrointestinal surgery (49.7 per 1,000 admissions) and the lowest after skin-soft tissue surgeries (15.5 per 1,000 admissions). Multivariate analysis identified dementia (OR = 3.19), end-stage kidney disease or dialysis (OR = 2.84), and metastatic cancer (OR = 2.65) as strong predictors of readmission. Advanced age (75+), male gender, primary cancer, and anemia were also independent predictors. Infection was the main reason for readmission. Other significant causes were hemorrhage, thrombosis/embolism, and intestinal obstruction. Conclusions The study highlights the importance of identifying risk factors for readmission to improve transitions of care. Targeted interventions for high-risk populations, particularly those with dementia, renal disease, or cancer, are essential to improve postoperative outcomes and alleviate the burden of unplanned readmissions on healthcare systems.https://doi.org/10.1186/s13037-025-00442-2 |
| spellingShingle | Gino Sartor Marco Fusco Marzio Milana Leonardo Rigon Giorgio Arcara Pierfranco Conte Alessandra Buja Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population Patient Safety in Surgery |
| title | Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population |
| title_full | Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population |
| title_fullStr | Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population |
| title_full_unstemmed | Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population |
| title_short | Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population |
| title_sort | risk factors for 30 day unplanned readmissions after surgical procedures in the elderly population |
| url | https://doi.org/10.1186/s13037-025-00442-2 |
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