Home E-Weekly March 11, 2014

How to Predict Post-Op Readmissions

Published: March 10, 2014

A simple-to-use online tool helps caregivers predict which patients are at risk of surgical complications and subsequent unplanned hospital readmissions, according to a study in JAMA Surgery.

Assessments of the admission records of more than 142,000 non-cardiac surgery patients showed that those who suffered any type of post-op complication were readmitted 78% of the time, as compared to a lower than 5% readmission rate for patients who enjoyed complication-free surgeries, say researchers at the University of Rochester (N.Y.) Medical Center.

The researchers note that the American College of Surgeons' Surgical Risk Calculator can help facilities flag patients likely to experience complications. Based on the tool's formula, patients at very high risk for major complications were 10 times more likely to be readmitted than low-risk patients, according to the study.

Patients deemed to be at high risk of suffering complications might be better cared for in a step-down unit or intensive care setting instead of the regular PACU, and should be closely monitored after discharge in order to identify and treat complications before they require hospitalization, says Laurent Glance, MD, the study's lead author and a professor of anesthesiology and public health sciences at the University of Rochester's School of Medicine and Dentistry.

Dr. Laurent notes that patients' complication risks could be added to their electronic health records to guide clinical decision-making during future surgeries.

"This information could also help with staffing," he adds. "Instead of taking care of 8 patients, a nurse might be assigned to monitor just 2 or 3 high-risk patients in an effort to prevent complications that could lead to more hospitalizations down the road."

Daniel Cook

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