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Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review
INTRODUCTION: Unplanned hospital readmissions after surgery contribute significantly to healthcare costs and potential complications. Identifying predictors of readmission is inherently complex and involves an intricate interplay between medical factors, healthcare system factors and sociocultural f...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10347775/ https://www.ncbi.nlm.nih.gov/pubmed/37442969 http://dx.doi.org/10.1186/s12893-023-02102-7 |
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author | Low, Zhao Kai Liew, Lydia Chua, Vanessa Chew, Sophia Ti, Lian Kah |
author_facet | Low, Zhao Kai Liew, Lydia Chua, Vanessa Chew, Sophia Ti, Lian Kah |
author_sort | Low, Zhao Kai |
collection | PubMed |
description | INTRODUCTION: Unplanned hospital readmissions after surgery contribute significantly to healthcare costs and potential complications. Identifying predictors of readmission is inherently complex and involves an intricate interplay between medical factors, healthcare system factors and sociocultural factors. Therefore, the aim of this study was to elucidate the predictors of readmissions in an Asian surgical patient population. METHODS: A two-year single-institution retrospective cohort study of 2744 patients was performed in a university-affiliated tertiary hospital in Singapore, including patients aged 45 and above undergoing intermediate or high-risk non-cardiac surgery. Unadjusted analysis was first performed, followed by multivariable logistic regression. RESULTS: Two hundred forty-nine patients (9.1%) had unplanned 30-day readmissions. Significant predictors identified from multivariable analysis include: American Society of Anaesthesiologists (ASA) Classification grades 3 to 5 (adjusted OR 1.51, 95% CI 1.10–2.08, p = 0.01), obesity (adjusted OR 1.66, 95% CI 1.18–2.34, p = 0.04), asthma (OR 1.70, 95% CI 1.03–2.81, p = 0.04), renal disease (OR 2.03, 95% CI 1.41–2.92, p < 0.001), malignancy (OR 1.68, 95% CI 1.29–2.37, p < 0.001), chronic obstructive pulmonary disease (OR 2.46, 95% CI 1.19–5.11, p = 0.02), cerebrovascular disease (OR 1.73, 95% CI 1.17–2.58, p < 0.001) and anaemia (OR 1.45, 95% CI 1.07–1.96, p = 0.02). CONCLUSION: Several significant predictors of unplanned readmissions identified in this Asian surgical population corroborate well with findings from Western studies. Further research will require future prospective studies and development of predictive risk modelling to further address and mitigate this phenomenon. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-023-02102-7. |
format | Online Article Text |
id | pubmed-10347775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103477752023-07-15 Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review Low, Zhao Kai Liew, Lydia Chua, Vanessa Chew, Sophia Ti, Lian Kah BMC Surg Research INTRODUCTION: Unplanned hospital readmissions after surgery contribute significantly to healthcare costs and potential complications. Identifying predictors of readmission is inherently complex and involves an intricate interplay between medical factors, healthcare system factors and sociocultural factors. Therefore, the aim of this study was to elucidate the predictors of readmissions in an Asian surgical patient population. METHODS: A two-year single-institution retrospective cohort study of 2744 patients was performed in a university-affiliated tertiary hospital in Singapore, including patients aged 45 and above undergoing intermediate or high-risk non-cardiac surgery. Unadjusted analysis was first performed, followed by multivariable logistic regression. RESULTS: Two hundred forty-nine patients (9.1%) had unplanned 30-day readmissions. Significant predictors identified from multivariable analysis include: American Society of Anaesthesiologists (ASA) Classification grades 3 to 5 (adjusted OR 1.51, 95% CI 1.10–2.08, p = 0.01), obesity (adjusted OR 1.66, 95% CI 1.18–2.34, p = 0.04), asthma (OR 1.70, 95% CI 1.03–2.81, p = 0.04), renal disease (OR 2.03, 95% CI 1.41–2.92, p < 0.001), malignancy (OR 1.68, 95% CI 1.29–2.37, p < 0.001), chronic obstructive pulmonary disease (OR 2.46, 95% CI 1.19–5.11, p = 0.02), cerebrovascular disease (OR 1.73, 95% CI 1.17–2.58, p < 0.001) and anaemia (OR 1.45, 95% CI 1.07–1.96, p = 0.02). CONCLUSION: Several significant predictors of unplanned readmissions identified in this Asian surgical population corroborate well with findings from Western studies. Further research will require future prospective studies and development of predictive risk modelling to further address and mitigate this phenomenon. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-023-02102-7. BioMed Central 2023-07-13 /pmc/articles/PMC10347775/ /pubmed/37442969 http://dx.doi.org/10.1186/s12893-023-02102-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Low, Zhao Kai Liew, Lydia Chua, Vanessa Chew, Sophia Ti, Lian Kah Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review |
title | Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review |
title_full | Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review |
title_fullStr | Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review |
title_full_unstemmed | Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review |
title_short | Predictors of unplanned hospital readmission after non-cardiac surgery in Singapore: a 2-year retrospective review |
title_sort | predictors of unplanned hospital readmission after non-cardiac surgery in singapore: a 2-year retrospective review |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10347775/ https://www.ncbi.nlm.nih.gov/pubmed/37442969 http://dx.doi.org/10.1186/s12893-023-02102-7 |
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