Reoperation following urgent and emergent colectomy in the State of Michigan

Abstract

BackgroundReoperation is associated with unfavorable outcomes and increased healthcare utilization. This study seeks to investigate the incidence and factors related to reoperation in patients undergoing urgent/emergent colectomies. MethodsThe Michigan Surgical Quality Collaborative (MSQC) database was used to identify patients undergoing urgent/emergent colectomies. Outcomes and risk factors of patients who underwent reoperation within 30 days were compared to those who did not. Results16,004 patients undergoing urgent/emergent colon resection were identified. Reoperation occurred in 12.4% and was associated with increased 30-day mortality (16.7% vs. 9.6%, p < .0001), median hospital length of stay (17 vs. 10 days, p < .0001), readmission rate (21.0% vs. 12.1%, p < .001), and discharge to a location other than home (62.3% vs. 36.8%, p < .0001). Reoperation rate was highest for vascular-related indications (23.5%), and was associated with several clinical factors (male gender, low albumin, ASA classification, and presence of pre-operative sepsis, dialysis or ventilator dependence) ConclusionsReoperation following urgent/emergent colectomy occurs frequently. Additional study into strategies to reduce reoperations in this population is warranted.