Unplanned readmission after surgery negatively impacts surgical recovery. Readmission following rectal cancer surgery may be reduced by the identification and modification of factors associated with readmission. This study sought to characterize the predictors of 30-day readmission following proctectomy for rectal cancer. The study was conducted at Beaumont Hospital, a nationally designated, publicly funded cancer center in Ireland. Two hundred forty-six consecutive patients who underwent proctectomy for rectal cancer between January 2012 and December 2015 were selected for this study. The primary outcomes measured were readmission within 30 days of discharge and the variables associated with readmission, categorized into patient factors, perioperative factors, and postoperative factors.
The study found thirty-one (12.6%) patients were readmitted within 30 days of discharge following index rectal resection. The occurrence of anastomotic leaks, high-output stoma, and surgical site infections was significantly associated with readmission within 30 days. Surgical site infections and high-output stoma maintained significant association on multivariate analysis. No significant difference was noted in the median length of stay or frequency of prolonged admissions (greater than 24 days) between readmitted and nonreadmitted patients.
The study concluded an early postoperative care bundle to detect postoperative complications could prevent some unnecessary inpatient admissions following proctectomy. Key constituents should include early identification and management of stoma-related complications and surgical site infection.
- Predictors of Readmission Following Proctectomy for Rectal Cancer. Diseases of the Colon & Rectum. February 8 2019