Unplanned readmission to hospital after colorectal surgery: how often does it happen and why?

This study examined how often and why patients are readmitted to hospital within 90 days of colorectal cancer surgery.

Treatment for colorectal cancer often involves surgery, which can be followed by chemotherapy. After a short recovery period in hospital most patients will continue their recovery at home. Unfortunately some patients suffer from complications during this recovery time and require unplanned readmission to hospital. Identifying the reasons for hospital readmission may reduce their occurrence and improve the quality of care provided to patients. 

This study examined the outcomes of 570 patients with colorectal cancer who underwent colorectal surgery. 71.2% of patients had colon cancer, 27.7% had rectal cancer and 1% of patients had both. The rate of hospital readmissions within 90 days of surgery, and the reasons for these readmission were examined.

The majority of patients had a short hospital stay after surgery, 1 to 7 days. 36% of patients suffered from surgery-related complications. 1.9% of patients died and 6.7% of patients spent more than 28 days in hospital after surgery. Overall, 32.8% of patients received chemotherapy within 90 days of surgery.

24.3% of patients had unexpected readmission to hospital within 90 days. 4.6% of these patients had more than 1 readmission during the 90 days. Of the 37 patients with a long hospital stay, 9 patients were readmitted within 90 days of surgery. 12.6% of patients were readmitted within the first 30 days of surgery. 8% of patients were readmitted between days 31 and 60 and 9.8% between days 61 and 90.

The most common reason for hospital readmission were wound infections (14.1% of readmissions), intestinal complaints (27% of readmissions; such as abdominal pain, vomiting or intestinal blockage) and chemotherapy-related complications (18.4% of readmissions; such as allergies, infections, nausea and vomiting). All wound-related readmissions happened within the first 60 days and 51% of readmissions between days 61 and 90 were due to complications of chemotherapy.

The authors concluded that most surgical-related readmission occurred within 60 days of surgery. They also reported that between days 61 and 90 a high rate of readmissions were due to chemotherapy-related complications.

These results are based on patients from one hospital with slightly higher than average readmission rates. Reasons for hospital readmission may be different in other hospitals.