Kelly et al identified a number of risk factors associated with unplanned 30-day readmission following a major gastrointestinal resection. These can help to identify a patient who may benefit from more aggressive management or an alternative therapy. The authors are from the University of Rochester.


Patient selection: major gastrointestinal resections (including pancreatic) in NSQIP database


Endpoint: 30-day unplanned readmission


Risk factors for unplanned readmission on multivariate analysis (with adjusted odds ratio > 1.2):

(1) major complication prior to discharge (sepsis or septic shock, organ space infection, venous thromboembolic event, significant organ injury (lung, heart, kidney, CNS), major blood transfusion

(2) chronic steroid use for an underyling condition

(3) operation time >= 4 hours

(4) not discharged home

(5) open procedure

(6) ASA class III, IV or V

(7) neurologic comorbidity

(8) bleeding disorder

(9) dependent functional status

(10) renal insufficiency



• Major blood transfusion was > 4 units within 72 hours of surgery


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