Patient selection: laparoscopic intestinal surgery
Outcome: unplanned readmission within 30-days
Reasons for readmission included:
(1) bowel obstruction
(2) ileus
(3) intra-abdominal abscess
(4) anastomotic leak
(5) fever
(6) dehydration
(7) pulmonary embolism
(8) wound infection
Predictors for readmission on multivariate analysis:
(1) inflammatory bowel disease
(2) pulmonary comorbidity
Additional factors associated with readmission:
(1) preoperative steroid use
(2) conversion to an open procedure
Early hospital discharge was not associated with readmission. This would be affected by the hospital's policies for early discharge after laparoscopic surgery.
One topic in the discussion is the importance of ileus for readmission. Alvimopan (a mu-opioid receptor antagonist) reduces readmission for ileus. Opiate postoperative analgesia may also influence readmission rates.
