Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

Sanjay Marwah; Priyanka Singla; Mahavir Singh; Himanshu Sharma

doi:10.18203/2349-2902.isj20170206

Authors

Sanjay Marwah Department of General Surgery, Pt. B.D. Sharma PGIMS Rohtak, Haryana, India
Priyanka Singla Department of General Surgery, Pt. B.D. Sharma PGIMS Rohtak, Haryana, India
Mahavir Singh Department of General Surgery, Pt. B.D. Sharma PGIMS Rohtak, Haryana, India
Himanshu Sharma Department of General Surgery, Pt. B.D. Sharma PGIMS Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20170206

Keywords:

Perforation peritonitis, Readmissio rate, Unplanned

Abstract

Background: Unforeseen re-admissions are a consequence of natural course of patient’s disease or results from sub-optimal care during first admission. Apart from causing increased expenditure, readmission immensely adds to the distress of the patient as well as his relatives. The aim of the study was to assess the incidence and risk factors for 30-day unplanned readmission following emergency laparotomy for perforation peritonitis.

Methods: This prospective observational study was conducted on 145 patients undergoing laparotomy for perforation peritonitis in over a period of two years. Various pre-operative, intra-operative and post-operative parameters were studied to identify the risk factors for readmission.

Results: Overall readmission rate was 8.96% and in majority of the cases it was due to post-surgical complications. Various factors found significant for readmission were American Society of Anaesthesiology (ASA) grade (p = 0.014) hypoproteinemia (p<0.001), diabetes mellitus (p = 0.001), immuno compromised status (p<0.001), stoma creation (p<0.001), blood transfusion (p = 0.022), renal complications and UTI (p = 0.027 each). On multivariate analysis, hypoproteinemia and stoma creation were found to be significant.

Conclusions: Risk factors for readmission among surgical patients are multi-factorial. Taking appropriate steps can reduce the burden of readmission. Moreover decreasing the rate of surgical readmission represents an opportunity to improve patient care.

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