Causes and Prevalence of Unplanned Readmissions After Colorectal Surgery: A Systematic Review and Meta-Analysis

Authors

  • Linda T. Li MD,

    Corresponding author
    1. Houston Veterans Affairs Health Services Research and Development Center of Excellence, Houston, Texas
    • Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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  • Whitney L. Mills PhD,

    1. Houston Veterans Affairs Health Services Research and Development Center of Excellence, Houston, Texas
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  • Donna L. White PhD, MPH,

    1. Houston Veterans Affairs Health Services Research and Development Center of Excellence, Houston, Texas
    2. Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas
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  • Alexa Li BS,

    1. Rice University, Houston, Texas
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  • Amanda M. Gutierrez,

    1. Rice University, Houston, Texas
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  • David H. Berger MD, MHCM,

    1. Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
    2. Houston Veterans Affairs Health Services Research and Development Center of Excellence, Houston, Texas
    3. Operative Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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    • Co-senior authors.
  • Aanand D. Naik MD

    1. Houston Veterans Affairs Health Services Research and Development Center of Excellence, Houston, Texas
    2. Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
    3. Medical Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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    • Co-senior authors.

Address correspondence to Linda T. Li, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Rm 404D, Houston, TX 77030. E-mail: linday@bcm.edu

Abstract

A systematic review and meta-analysis of the current literature was conducted to compare the overall and cause-specific readmission rates after colorectal surgery of older adults with those of younger individuals. Potential predictors of unplanned readmission were also identified. Estimated pooled readmission rates were calculated and reported as pooled proportions with associated 95% confidence intervals (CI) in 60,131 total readmissions; 11.0% (95% CI = 10.0–12.0) of all admissions after colorectal surgery resulted in unplanned readmission at 30 days. Older adults had a lower rate of readmission than younger individuals. Bowel obstruction was the most common cause of unplanned readmission, accounting for 33.4% of all unplanned readmissions, followed by surgical site infection (15.7%) and intraabdominal abscess (12.6%). Several age-related predictors of unplanned readmission were identified, such as poor functional capacity, multiple comorbidities, chronic obstructive pulmonary disease, and discharge to a nonhome destination. The findings of this review will help guide the development of future interventions to reduce preventable readmissions after colorectal surgery in older adults.

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