eP594 - Identifying Patients at Risk of Readmission After Lower Anterior Resection for Rectal Cancer

Purpose/Background: Readmission is a costly complication for lower anterior resection (LAR) and often utilized as a measure of surgical outcomes. Many attempts are made to decrease readmission rate on a regular basis. Unfortunately, 6 to 25% of patients still require readmission, and additional studies targeting patients who are at higher risk can provide additional insight.Methods/Interventions: This is a retrospective, multicenter observational study examining patients who underwent a lower anterior resection for rectal adenocarcinoma from 2016 to 2019. We looked at all patients undergoing readmission within 30 days of surgery. Independent student t-test was utilized for quantitative data, while Fischer’s Exact Test and Chi-squared test was utilized for qualitative data. P-value less than 0.05 was deemed statistically significant.Results/Outcomes: A total of 199 patients were included in this study. 23 (11.6%) 30-day readmissions were noted. The most common complications were GI related issues including bowel obstruction, ileus, and rectal bleeding (39.1%) followed by infections such as surgical site infections or sepsis (21.7%). Patients who required emergent surgery were more likely to require readmission than patients underwent elective surgery (44.4% versus 13.3%; p = 0.029). Patients with surgeries longer than 250 minutes were more likely to be readmitted (25.4% versus 10.7%; p = 0.042) as well as patients whose hospital length of stay was equal or greater than 7 days (24% versus 12.1%; p = 0.015). Additionally, patients who were discharged to skilled nursing facility (SNF) were more likely to be readmitted compared to their home or home health counter parts (66.6% versus 11.9% versus 15.2%; p = 0.002). Sex, BMI, age, enhanced recovery after surgery (ERAS) implementation status, and surgical technique (e.g., open, laparoscopic, robotic) did not impact 30-day readmission status.Conclusion/

Discussion: Patients who undergo LAR emergently, experienced surgery time of greater than 250 minutes, stayed in the hospital 7 days or greater postoperatively, or required SNF placement, are more likely to be readmitted within 30 days. This is most likely secondary to their more debilitated postoperative state and medical co-morbidities. Extra attention, care, and patient education should be encouraged in this particular patient population prior to surgery.