Patients who are readmitted to a hospital after a major operation are more likely to survive subsequent complications if they return to the hospital where their surgery took place, according to a study published June 17 in The Lancet.
Lead author Benjamin S. Brooke, MD, and colleagues examined data from 9,440,503 Medicare beneficiaries who underwent 12 common high-risk operations: open abdominal aortic aneurysm repair, infrainguinal arterial bypass, aortobifemoral bypass, coronary artery bypass surgery, esophagectomy, colectomy, pancreatectomy, cholecystectomy, ventral hernia repair, craniotomy, hip replacement, or knee replacement. The number of patients rehospitalized with complications within 30 days of their operation ranged from 5.6% (15,4203) of patients undergoing knee replacement to 22% (3,665) of patients undergoing esophagectomy. The researchers found that patients readmitted to the same hospital were 26% less likely to die within 90 days than those readmitted to a different hospital, even after accounting for measures of surgical quality that can affect mortality, such as the hospital’s size, teaching status, and volume of procedures.
“Our findings suggest that maintaining continuity of care when readmissions occur is a more important predictor of survival than other established surgical quality measures, such as hospital procedure volume, and needs to be considered in the trade-offs when choosing a hospital for surgery,” said Dr. Brooke.