Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 9;5(2):e417.
doi: 10.1097/AS9.0000000000000417. eCollection 2024 Jun.

Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study

Michael H McGillion  1   2 , Flavia K Borges  2   3 , David Conen  2   3   4 , Daniel I Sessler  5 , Brenda L Coleman  6   7 , Maura Marcucci  2   3   4 , Carley Ouellette  1 , Marissa Bird  1 , Carly Whitmore  1 , Shaunattonie Henry  1 , Sandra Ofori  2   4 , Shirley M Pettit  2 , Deborah M Bedini  8 , Leslie P Gauthier  9 , Jennifer Lounsbury  1   9 , Nancy M Carter  1 , Vikas Tandon  3 , Ameen Patel  3   9 , Teresa Cafaro  2   4 , Marko R Simunovic  9   10 , John A Harlock  8   10 , Diane Heels-Ansdell  4 , Fadi Elias  10 , Theodore Rapanos  10 , Shawn Forbes  9   10 , Elizabeth Peter  11 , Judy Watt-Watson  11 , Kelly Metcalfe  11 , Sandra L Carroll  1   2 , Philip J Devereaux  2   3   4
Affiliations

Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study

Michael H McGillion et al. Ann Surg Open. .

Abstract

Objective: To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery.

Background: Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability.

Methods: We undertook an international (28 centers, 14 countries) prospective cohort study of a representative sample of adults ≥45 years of age who underwent noncardiac surgery. Risk factors for readmission were assessed using Cox regression (ClinicalTrials.gov, NCT00512109).

Results: Of 36,657 eligible participants, 2744 (7.5%; 95% confidence interval [CI], 7.2-7.8) were readmitted within 30 days of discharge. Rates of readmission were highest in the first 7 days after discharge and declined over the follow-up period. Multivariable analyses demonstrated that 9 baseline characteristics (eg, cancer treatment in past 6 months; adjusted hazard ratio [HR], 1.44; 95% CI, 1.30-1.59), 5 baseline laboratory and physical measures (eg, estimated glomerular filtration rate or on dialysis; HR, 1.47; 95% CI, 1.24-1.75), 7 surgery types (eg, general surgery; HR, 1.86; 95% CI, 1.61-2.16), 5 index hospitalization events (eg, stroke; HR, 2.21; 95% CI, 1.24-3.94), and 3 other factors (eg, discharge to nursing home; HR, 1.61; 95% CI, 1.33-1.95) were associated with readmission.

Conclusions: Readmission following noncardiac surgery is common (1 in 13 patients). We identified perioperative risk factors associated with 30-day readmission that can help frontline clinicians identify which patients are at the highest risk of readmission and target them for preventive measures.

Keywords: cohort study; hospital readmission; noncardiac surgery; risk factors.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Flow chart of participants in VISION 30-day readmission following discharge.
FIGURE 2.
FIGURE 2.
Number and cumulative percent of patients readmitted to hospital within 30 days of discharge following noncardiac surgery. Gray (column) bars and numbers on left vertical (y) axis indicate the number of readmissions per day since discharge from hospital. Black line and numbers on the right/secondary vertical (y) axis indicate the cumulative percent of patients readmitted since discharge.
See this image and copyright information in PMC

References

    1. Weiser TG, Regenbogen SE, Thompson KD, et al. . An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008;372:139–144. - PubMed
    1. Devereaux PJ, Sessler DI. Cardiac complications in patients undergoing major noncardiac surgery. N Engl J Med. 2015;373:2258–2269. - PubMed
    1. Bae JY, Groen RS, Kushner AL. Surgery as a public health intervention: common misconceptions versus the truth. Bull World Health Organ. 2011;89:394. - PMC - PubMed
    1. Glance LG, Kellermann AL, Osler TM, et al. . Hospital readmission after noncardiac surgery: the role of major complications. JAMA Surg. 2014;149:439–445. - PubMed
    1. Canadian Institute for Health Information. All-Cause Readmission to Acute Care and Return to the Emergency Department. 2012. Available at: https://publications.gc.ca/site/eng/9.698629/publication.html. Accessed August 12, 2023.

Associated data