Readmissions more likely when hysterectomy performed abdominally versus vaginally
THURSDAY, Sept. 15, 2016 (HealthDay News) — For patients undergoing hysterectomy for benign indications, the 30-day readmission rate is 2.8 percent, with most readmissions occurring within 15 days, according to a study published in the October issue of Obstetrics & Gynecology.
Courtney A. Penn., M.D., from the University of Michigan Health System in Ann Arbor, and colleagues performed a retrospective analysis to examine patterns of 30-day readmission after hysterectomy for benign indications, including all surgical approaches (abdominal, laparoscopic, and vaginal).
The researchers found that the 30-day readmission rate was 2.8 percent, and readmissions were seen for 3.7, 2.6, and 2.1 percent of abdominal, laparoscopic, and vaginal hysterectomies, respectively. Compared with a vaginal approach, readmissions were more likely when hysterectomy was performed abdominally (adjusted odds ratio, 1.45; 95 percent confidence interval, 1.2 to 1.76) but not laparoscopically (adjusted odds ratio, 1.1; 95 percent confidence interval, 0.9 to 1.4). Most readmissions (82 percent) occurred within 15 days of discharge. The shortest and longest median times to readmission (three and 10 days) were associated with pain and noninfectious wound complications, respectively. The most common diagnosis was surgical site infection (36.6, 28.3, and 32.6 percent of abdominal, laparoscopic, and vaginal hysterectomies, respectively); surgical site infections, surgical injuries, and wound complications accounted for about half of all readmissions (51.5, 51.9, and 50.8 percent, respectively).
“Readmission reduction efforts should focus on early postdischarge follow-up, preventing infectious complications, and determining preventability of surgical-related reasons for readmission,” the authors write.
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