Risk Factors Contributing To Unplanned Readmission Within 30 Days Of Discharge After Colorectal Cancer Surgery

Objective: To investigate the incidence of unplanned readmission within 30 days of discharge after colorectal cancer surgery,and to analyze the risk factors for unplanned readmission.Methods: Clinical data of patients who underwent radical colorectal cancer surgery in The Department of General Surgery of Zhongda Hospital affiliated to Southeast University from January 1,2014 to December 31,2020 were collected.Patients were divided into readmission group and non-readmission group based on readmission criteria,and the risk factors for readmission within 30 days after discharge were analyzed.Results: A total of 1689 patients diagnosed with colorectal cancer were hospitalized,and 325 were excluded based on exclusion criteria.Among 1364 patients undergoing radical colorectal cancer surgery,112 had unplanned readmission within 30 days of discharge,with an 8.1% incidence of unplanned readmission.The most common reasons for readmission were abdominal discomfort,intestinal obstruction,and incision infection.Of the 112 readmitted patients,108 were well and discharged,and4 died during readmission.Unplanned reoperation was performed in 12 patients during readmission.In univariate analysis,cardiac complications(coronary heart disease and atrial fibrillation),stoma,intraoperative blood loss,and postoperative nosocomial complications were significantly associated with unplanned readmission.Multivariate binary Logistic analysis showed that cardiac complications(P=0.032)and postoperative nosocomial complications(P < 0.01)were significantly correlated with unplanned readmission.Patients with moderately differentiated tumor s(P=0.024)were significantly associated with unplanned readmission compared with those highly differentiated tumors.Conclusion: Cardiac complications and postoperative nosocomial complications(The main complications were incision complications,anastomotic leakage and intestinal obstruction)are high-risk factors for unplanned readmission within 30 days after discharge.Patients with well-differentiated tumors were more likely to be readmitted within 30 days of discharge.