Key result
Following anorectal surgery, 8.2% of patients had an unplanned return to care within 7 days, with half of these returns due to potentially avoidable diagnoses such as pain and constipation.
Why the study?
Unanticipated returns after anorectal surgery remain a major issue, with rates reported up to 50 per cent.
What are the causes, frequency, and timing of unplanned returns to care within seven days after anorectal surgery?
Cohort (n=5,929)
Yes
What are the causes, frequency, and timing of unplanned returns to care within seven days after anorectal surgery?
Half of unplanned returns to care within seven days after anorectal surgery are due to potentially avoidable causes such as pain, constipation, urinary retention, and nausea/vomiting, suggesting a role for preemptive interventions.
Answers are grounded in this paper and cite their sources.
May identify avoidable causes of post-anorectal returns; leaves open whether interventions reduce unplanned care.
With rates up to 50 per cent, unanticipated returns after anorectal surgery remain a major issue. A retrospective analysis was performed on 5929 anorectal operations from January 2011 to December 2015 across 14 Kaiser Permanente Southern California medical centers. Data were gathered on the cause, frequency and timing of unplanned returns to the ED and urgent care. Of all patients, 246 (4%) returned with a nonavoidable diagnosis and 243 (4%) returned with one of four avoidable diagnoses: pain, constipation, urinary retention, and nausea/vomiting. Seventy four per cent of avoidable diagnoses returns occurred within the first four postoperative days, with 48 per cent between days 2 and 4. In patients older than 50 years of age, males showed higher urinary retention (P = 0.001), whereas females had higher constipation (P < 0.001). Contrarily, pain was higher for both males (P = 0.02) and females (P < 0.001) less than 50 years old. In a separate subanalysis on anesthesia type, both constipation (P = 0.03) and urinary retention (P = 0.01) showed double the return rate in the general versus local/monitored anesthesia care group, whereas pain (P = 0.15) and nausea/vomiting (P = 0.20) showed no differences. Half of returns fall into a category that is potentially avoidable with preemptive interventions.
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Crain et al. (2019) conducted a cohort in Anorectal surgery (n=5,929). Anorectal surgery was evaluated on Unplanned returns to the ED and urgent care. Following anorectal surgery, 8.2% of patients had an unplanned return to care within 7 days, with half of these returns due to potentially avoidable diagnoses such as pain and constipation.
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