Readmission After Surgery Most Frequently Caused By Hospital Infections: Study

Following surgery, the most common reason for complications that result in re-admission are hospital-acquired infections, according to the findings of a new study. 

Researchers from the American College of Surgeons and Northwestern University looked at nearly half a million surgical operations performed in the U.S. over the course of one year, and found that 20% of all unplanned re-admissions to the hospital within a month of the procedure were due to surgical site infections.

In the study published in the Journal of the American Medical Association (JAMA) on on February 3, researchers examined data collected on surgeries conducted at 346 U.S. hospitals in 2012, which participated in the American College of Surgeons National Surgical Quality Improvement Program.

While they looked at all surgical procedures, the researchers focused on six representative operations, including bariatric surgery, colectomy or proctectomy, hysterectomy, total hip or knee arthroplasty, ventral hernia repair, and lower extremity vascular bypass.

Out of the 498,875 surgeries reported, researchers found that 5.7% resulted in unplanned readmissions after just 30 days, which is considered a sign that there was some form of surgical complication.

The most common reason for readmission given was surgical site infections, which were responsible for 19.5% of readmissions. Lower extremity vascular bypass was the surgery most associated with readmissions, with 14.9% of patients who underwent the procedure back in the hospital in less than a month. Surgical site infections were responsible for more than a third of those cases.

The study found little correlation between complications noted at the time of the surgeries and whether a patient returned.

“Readmission after surgery was associated with new postdischarge complications related to the procedure and not exacerbation of prior index hospitalization complications, suggesting that readmissions after surgery are a measure of postdischarge complications,” the researchers concluded. “These data should be considered when developing quality indicators and policies penalizing hospitals for surgical readmission.”

Surgical Site Infections

The findings come about a year after researchers from RAND Corporation and the Center for Health Policy at Columbia University published a study suggesting that many hospitals are not following infection guidelines or providing enough support to infection prevention efforts.

A report issued by the U.S. Center for Disease Control and Prevention (CDC) concluded one out of every 25 hospital patients acquires an infection. In 2011, nearly 75,000 patients died after contracting infections they did not have when first admitted. Another study published in 2013 revealed hospital acquired infections cost the U.S. health care system nearly $10 billion each year.

Surgical site infections cost about $21,000 per patient and have the greatest financial impact on health care. Because of how often they occur, SSIs accounted for 33% of the total cost of hospital-acquired infections.

In recent years, an increasing number of medical malpractice lawsuits over hospital infections are being filed, as many experts believe that these infections can be prevented with the exercise of reasonable care.