Key result
Readmission 1 to 5 days after high-risk surgery is linked to ~388% higher 90-day mortality.
Why the study?
Little progress has been made toward understanding why only some surgical readmissions lead to adverse outcomes such as increased mortality.
Does time-to-readmission impact mortality in Medicare beneficiaries undergoing high-risk surgery?
Population
1,033,255 Medicare beneficiaries undergoing colectomy, lung resection, or CABG from 2005 to 2009
Comparison
Time-to-readmission groups versus no 30-day readmission
Design
Retrospective cross-sectional cohort analysis
Follow-up
30, 60, and 90 days
Authors
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Early readmission after high-risk surgery signals higher 90-day mortality; hypothesis-generating for targeted interventions, should not yet change practice.
Cohort (n=1,033,255)
Yes
Does time-to-readmission impact mortality in Medicare beneficiaries undergoing high-risk surgery?
Odds Ratio: 4.88 (95% CI 4.72–5.05)
p-value: p=<0.001
Surgical readmissions within 10 days of discharge are associated with significantly higher mortality compared to later readmissions, independent of index complications.
Gonzalez et al. (2014) conducted a cohort in High-risk surgery (colectomy, lung resection, or coronary artery bypass grafting) (n=1,033,255). Readmission within 1 to 5 days vs. No 30-day readmission was evaluated on 90-day mortality (OR 4.88, 95% CI 4.72-5.05, p=<0.001). Readmission within 1 to 5 days after high-risk surgery was associated with increased 90-day mortality compared to no readmission (12.6%; OR 4.88; 95% CI 4.72-5.05; P<0.001).
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