Lower Risk of Death If Patients Return To Same Hospital For Complications: Study

Patients who undergo surgery and later experience complications resulting in the need for readmission to the hospital appear to fare better if they return to the same facility, as opposed to going to a different hospital, according to the findings of new research.

In a study published last month in the medical journal The Lancet, researchers found patients readmitted to the hospital where their surgery was first conducted are 26% less likely to die three months later than patients who are readmitted to a different hospital than the one where the original surgery was conducted.

Hospital readmissions are common after patients undergo a major surgery. Yet, researchers wanted to assess the correlation between readmissions at the initial hospital and at a different hospital with mortality risk. The study analyzed more than 9 million Medicare patients who underwent surgery in the U.S. between January 1, 2001, to November 15, 2011.

Patients underwent one of 12 different surgeries, including arterial bypass, coronary artery bypass, open abdominal aortic aneurysm repair, colectomy, pacreatectomy, hernia repair, craniotomy and hip or knee replacements.

Between six percent and 85% of patients were readmitted to the hospital within one month after the initial surgery, depending on what type of surgery was conducted. More than half the time patients were transferred or readmitted to the hospital where they had the initial surgery.

Those that returned to the original hospital were less likely to die within three months, compared to those who were readmitted to a different hospital. Those patients were also often readmitted one or two days earlier than those who went to different hospitals.

A study published earlier this year revealed the most common reason for hospital readmission was due to hospital-acquired infections. The study found 20% of all unplanned readmissions to the hospital within a month of the initial surgery were caused by surgical site infections.

In this latest study, patients with the highest probability of returning to the original hospital had an eight percent lower risk of death than patients who were less likely to be readmitted to the original hospital.

Researchers speculate the reason for the decreased risk of death may be surgeons who perform the initial surgeries take the time to thoroughly perform the big operation. They get to know the area being operated on, how the surgery went and if there were complications. Doctors who did not perform the original surgery will not have the information from the first surgery to be able to put the readmission or complication into context.

Another study published in May in the U.S. News & World Report on Hospital Quality revealed patients undergoing surgical procedures at smaller hospitals may face a higher risk of severe complications and death compared to patients operated on at busier hospitals. Researchers say this may be due to a lack of sufficient practice for surgical teams.

Some patients will travel outside of their local area to have a more complex operation performed at a larger more prestigious hospital. However, when complications arise later, they will be admitted to a hospital closer to where they live under the care of a doctor who is unfamiliar with their condition or surgery.