Abstract Rationale Readmissions within 30 days after surgery represent a key quality indicator and a major burden on healthcare systems, especially among older adults. In nonagenarians, limited physiological reserve and multimorbidity may amplify vulnerability to perioperative stressors. Understanding the determinants of early readmission in this high-risk group can guide targeted perioperative interventions. This study aimed to identify predictors of 30-day readmission among surgical patients aged 90 years or older in a fourth-level hospital in Colombia. Methods We conducted a retrospective cohort study using a multicenter surgical database from 2020 to 2024. All patients aged ≥90 years who underwent surgery during this period were included. The primary outcome was 30-day readmission following hospital discharge. Independent variables included age, sex, American Society of Anesthesiologists (ASA) physical status classification, urgency of procedure, anesthesia duration, intraoperative vasopressor use, blood transfusion, postoperative delirium, and in-hospital mortality. Descriptive statistics and comparative analyses were performed between readmitted and non-readmitted patients. Statistical significance was set at p 0.05. Results A total of 206 patients were analyzed, of whom 32 (15.5%) were readmitted within 30 days. Compared with those not readmitted, readmitted patients more frequently developed postoperative delirium (31.2% vs. 10.3%) and required intraoperative vasopressors (50% vs. 41.4%). Blood transfusion (21.9% vs. 17.8%) and prolonged anesthesia duration (31.2% vs. 19.5%) were also more common in the readmitted group. Mean ASA class was slightly higher among readmitted patients (2.10 vs. 1.94). No significant differences were found in age or in-hospital mortality between groups. These results suggest that intraoperative hemodynamic instability and postoperative delirium may play an important role in predicting early readmission among very elderly surgical patients. Conclusions Thirty-day readmission occurred in approximately one in six nonagenarian surgical patients and was associated with intraoperative vasopressor use, transfusion, prolonged anesthesia, and delirium. These findings indicate that both intraoperative instability and postoperative cognitive dysfunction may serve as modifiable targets to improve recovery and reduce healthcare burden. Prior research supports the relevance of postoperative delirium and hemodynamic fluctuations as predictors of adverse recovery trajectories in older adults (1). Interventions to stabilize hemodynamics and prevent delirium may help reduce early readmission risk in this vulnerable population. REFERENCES: 1. Lee A, Lum ME. Delayed post-operative recovery: role of preoperative nutritional status. ANZ J Surg.2014;84(5):314-318. This abstract is funded by: none
Montoya et al. (Fri,) studied this question.