Incidence, Causes, and Predictors of 30-Day Hospital Readmission Following Surgical Procedures: A prospective Cohort study

Abstract

Background: Hospital readmission rates within 30 days of surgery are a key quality indicator associated with postoperative complications, slower recovery, and higher healthcare costs. This study evaluated the incidence, causes and risk factors associated with early (30-day) hospital readmissions following common surgical procedures. Methods: This study was conducted with 250 consecutive patients who were discharged after elective or emergency surgery. Medical records and 30-day follow-up (unplanned hospitalization within 30 days after discharge) documentation were used to obtain demographic, clinical, and operative and postoperative data. The data were analysed using SPSS version 26.0. Independent-samples t-test, chi-square test or Fisher's exact test were used to compare groups and multivariable logistic regression was used to identify factors independently associated with 30-day readmission, with adjusted odds ratios (OR) and 95% confidence intervals (CI). A p<0.05 was considered statistically significant. Results: There were 47 patients (18.8%) who were readmitted in 30 days. The most frequent causes were surgical site infection 15 (31.9%), uncontrolled postoperative pain 11 (23.4%) and wound dehiscence 8 (17.0%). Patients who were readmitted were hospitalized for a longer time period than patients who were not readmitted (8.2±3.6 days vs. 5.4±2.3 days, p<0.001). Postoperative complications (AOR=3.68), hospital stay >7 days (AOR=3.12), emergency surgery (AOR=2.76), diabetes mellitus (AOR=2.41), and age ≥60 years (AOR=2.18) were independent predictors. Conclusion: Nearly 20% of surgical patients were readmitted within 30 days. Improved infection prevention, discharge planning, postoperative pain management, and early detection and management of complications may reduce avoidable readmissions and improve postoperative outcomes.