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Session: ePoster Monitor 3-Quality and Cost 2

eP299 - Predicting Readmission Following Elective Same Day Colectomy

Sunday, June 2, 2024
11:27 AM – 11:32 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Alexandra E. Hernandez, MD, MPH (she/her/hers)

    Postdoctoral Scholar
    University of Miami/Jackson Health System
    University of Miami / Jackson Health System
    Miami, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • SK

    Shayan Khalafi, MD

    General Surgery Resident
    University of Miami/Jackson Health System
    Miami, Florida, United States

    Disclosure information not submitted.

  • KK

    Karishma Kodia, MD

    Resident Physician
    University of Miami / Jackson Memorial Hospital
    Miami, Florida, United States

    Disclosure information not submitted.

  • CB

    Cristina Botero Fonnegra, MD

    General Surgery Resident
    University of Miami/Jackson Health System
    Miami, Florida, United States

    Disclosure information not submitted.

  • AR

    Ana Reyes, MD/MPH

    Resident
    University of Miami/Jackson Memorial Hospital
    Miami, Florida, United States

    Disclosure information not submitted.

  • Matthew S. Meece, MD

    Resident
    Jackson Health System/University of Miami
    Jackson Health System/University of Miami
    Miami, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • AJ

    Alricka Jakcson, MD

    Resident Physician
    University of Miami/Jackson Memorial
    Miami, Florida, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • VH

    Vanessa W. Hui, MD

    Assistant Professor of Clinical Surgery
    University of Miami
    SOUTH MIAMI, Florida, United States

    Disclosure information not submitted.

Purpose/Background: Enhanced recovery programs (ERPs) for minimally invasive colorectal surgery have led to shorter hospital stays. Same-day discharge (SDD) programs are evolving from ERPs, focusing on minimizing factors like delayed gastrointestinal recovery, enhancing pain management, and providing effective post-discharge follow-up to enable select patients to go home on the day of surgery. However, proper patient selection for SDD is essential for achieving successful outcomes. Therefore, we sought to investigate patient risk factors for readmission after same-day minimally invasive colectomy in a nationally representative cohort.Methods/Interventions: Using the National Surgical Quality Improvement Program (NSQIP) database from the years 2015-2021, we analyzed patients who underwent same day colectomy procedures (CPT codes 44204, 44205, 44207, and 44208). Same-day discharge was classified as hospital length of stay of 0-1 days. The main outcome was 30-day readmission. We used logistic regression models to evaluate predictors of 30-day readmission after SDD.Results/Outcomes: Leveraging recent NSQIP data, we identified 5,445 patients with LOS of 0 or 1. Of these 5.2% (n=281) had a readmission. Median (IQR) age was 62 (52-70) years for those readmitted, and 60 (51-68) years for those not readmitted. Patients who were readmitted had a significantly higher proportion of a primary diagnosis of colorectal malignancy (41.6%) compared to those who were not readmitted (41.6% vs 32.2%, p < 0.05). On univariate analysis, statistically significant factors predictive of readmission in same day colectomy patients were increased BMI (p < 0.005), a modified frailty index of 2 or greater (p < 0.05), increased operative time (p < 0.05), and if an ileal resection was performed (p < 0.05). On multivariate analysis, all previously identified factors apart from the preoperative diagnosis remained statistically significant.Conclusion/

Discussion: This study provides crucial insights into readmission patterns and risk factors for same day colectomy patients. It enhances our understanding of managing this specialized surgical population, facilitating the refinement of surgical practices and strategies to mitigate readmission risks. Using the patient and surgical factors identified in our study, we can better select the population that would most benefit from SDD following elective colectomy. Further research is needed to validate these findings and guide clinical decision-making, ultimately improving patient outcomes and healthcare efficiency in the era of same day colectomy procedures.Table 1. Univariable and Multivariable Analysis of Predictors of Readmission in Same-Day Colectomy PatientsTable 1. Univariable and Multivariable Analysis of Predictors of Readmission in Same-Day Colectomy Patients