Avoiding Hospital Readmission After Surgery

By Jane Farrell

Patients with post-surgical complications are likelier to be readmitted within 30 days than are those that don’t have the complications, according to a study published in JAMA Surgery. The research also found that using a simple online tool can help health-care practitioners predict which patients are at high risk of readmission.

For the study, investigators from the University of Rochester analyzed more than 142,000 patients who had non-cardiac surgery. After taking into account the severity of disease and the complexity of surgery, they found that the rate of unplanned readmissions was 78 percent for those with complications. Among the group that did not have complications, the readmission rate was less than 5 percent.

Currently, hospitals do not have a way to identify surgical patients who are at high risk for unplanned re-hospitalizations. But, there is an online tool – the American College of Surgeon’s Surgical Risk Calculator – that allows health care professionals to enter patient information like age, body mass index and smoking status and get an estimate of the patient’s risk of complications.

 “If a patient’s predicted risk of complications is high, which we’ve shown puts them at greater risk of readmission, a physician might decide to move the patient to the intensive care unit or a step-down unit after surgery, as opposed to a regular hospital unit that manages less sick patients,” said Laurent G. Glance, M.D., lead study author and professor in the Departments of Anesthesiology and Public Health Sciences.

“This information could also help with staffing. Instead of taking care of eight patients, a nurse might be assigned to monitor just two or three high-risk patients in an effort to prevent complications that could lead to more hospitalizations down the road.”