Highlights
- •Reoperation following emergent/urgent colectomy is associated with increased mortality and pronounced healthcare utilization.
Abstract
Background
Reoperation is associated with unfavorable outcomes and increased healthcare utilization.
This study seeks to investigate the incidence and factors related to reoperation in
patients undergoing urgent/emergent colectomies.
Methods
The Michigan Surgical Quality Collaborative (MSQC) database was used to identify patients
undergoing urgent/emergent colectomies. Outcomes and risk factors of patients who
underwent reoperation within 30 days were compared to those who did not.
Results
16,004 patients undergoing urgent/emergent colon resection were identified. Reoperation
occurred in 12.4% and was associated with increased 30-day mortality (16.7% vs. 9.6%,
p < .0001), median hospital length of stay (17 vs. 10 days, p < .0001), readmission
rate (21.0% vs. 12.1%, p < .001), and discharge to a location other than home (62.3%
vs. 36.8%, p < .0001). Reoperation rate was highest for vascular-related indications
(23.5%), and was associated with several clinical factors (male gender, low albumin,
ASA classification, and presence of pre-operative sepsis, dialysis or ventilator dependence)
Conclusions
Reoperation following urgent/emergent colectomy occurs frequently. Additional study
into strategies to reduce reoperations in this population is warranted.
Graphical abstract
Graphical Abstract
Keywords
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References
- Is unplanned return to the operating room a useful quality indicator in general surgery?.Arch Surg. 2001; 136: 405-411
- Prioritizing quality improvement in general surgery.J Am Coll Surg. 2008; 207: 698-704
- Reoperation as a quality indicator in colorectal surgery: a population-based analysis.Ann Surg. 2007; 245: 73-79
- Patient perspectives on defining textbook outcomes following major abdominal surgery.J Gastrointest Surg. 2022; 26: 197-205
- How often do patients return to the operating room after colorectal resections?.Colorectal Dis. 2012; 14: 515-521
- ESPEN guideline: clinical nutrition in surgery.Clin Nutr. 2017; 36: 623-650
- Hospital volume and surgical mortality in the United States.N Engl J Med. 2002; 346: 1128-1137
- Unplanned reoperation following colorectal surgery: indications and operations.J Gastrointest Surg. 2017; 21: 1480-1485
- Reoperation after colorectal surgery is an independent predictor of the 1-year mortality rate.Dis Colon Rectum. 2011; 54: 1438-1442
- Surgical wound misclassification: a multicenter evaluation.J Am Coll Surg. 2015; 220: 323-329
Article Info
Publication History
Published online: November 08, 2022
Accepted:
November 4,
2022
Received in revised form:
October 13,
2022
Received:
July 8,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
☆The manuscript has been seen and approved by all authors and the content within is previously unpublished.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
