Wednesday, 4 February 2015

Infection Most Likely Cause of Hospital Readmission After Surgery


Knowing why readmissions happen is first step in reducing them, researcher says

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

TUESDAY, Feb. 3, 2015 (HealthDay News) -- Infections are the most likely reason people end up back in the hospital after surgery, a new study finds.

Of nearly 500,000 operations studied, 6 percent of the patients were readmitted for surgical complications within a month after their surgery, researchers found.

The number one complication leading to readmission was surgical wound infection, said lead researcher Dr. Karl Bilimoria, an assistant professor of surgery at Northwestern University Feinberg School of Medicine in Chicago.

"Readmissions after surgery are not due to mismanagement or poor care. They are related to well-known and well-accepted complications after surgery," Bilimoria said.

He added that knowing why readmissions happen is the first step in reducing them.

Currently, the U.S. Centers for Medicare & Medicaid Services can penalize hospitals for excessive readmission rates. "We don't have the answers to how to reduce this complication, but penalizing hospitals [financially] for these infections isn't effective," Bilimoria stressed.

The report was published Feb. 3 in the Journal of the American Medical Association.

The researchers looked at readmission rates and reasons for all operations in nearly 350 U.S. hospitals. They also looked in greater detail at six commonly performed operations that are often included in public reporting and as measures in pay-for-performance programs.

These surgeries included: weight-loss surgery (bariatric procedures); removal of all or part of the colon (colectomy or proctectomy); removal of the uterus (hysterectomy); total hip or knee replacement; stomach hernia repair (ventral hernia repair); and bypass surgery of leg arteries.

The study found that the rate of readmission for any complication after surgery ranged from less than 4 percent after hysterectomy to 15 percent after leg artery bypass surgery.

Overall, the most common reason for readmission was infection at the site of the surgery, ranging from 11 percent after bariatric surgery to 36 percent after leg artery bypass, the investigators found.

The second most common reason for readmission overall was obstruction or restriction of the normal movement of the intestine (known as "ileus") after colectomy, proctectomy, ventral hernia repair and hysterectomy, the study authors said. However, these intestinal complications were the most common reason for readmission after weight-loss surgery.

source : Infection Most Likely Cause of Hospital Readmission After Surgery

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