Risk Factors for Readmission Due to Infection after Cesarean Delivery [26D

Abstract

INTRODUCTION: Postpartum infections are major cause of prolonged hospital stay and burden to health care system. Wound infection or breakdown is a second most common reason for hospital readmission. Data regarding risk factors for hospital readmission due to infection are limited. METHODS: This is a retrospective study of women undergoing cesarean delivery at 23 weeks’ gestation or greater at MedStar Washington Hospital Center. The hospital readmission due to infection is defined as hospital readmission due to the following indications: endometritis, deep wound infection, and other infections (abdominopelvic abscess, maternal sepsis, pelvic septic thrombophlebitis, pyelonephritis, pneumonia, or meningitis) occurring after discharge and up to 6 weeks after cesarean delivery. Maternal demographics, maternal comorbidities, and labor and delivery outcomes were compared between women without hospital readmission due to infection and women with hospital readmission due to infection. Multivariable logistic regression analysis was performed to calculate adjusted odds ratio (aOR) with 95% confidence intervals (95%CI), controlling for significant variables in the bivariate analysis. RESULTS: Of 3805 women undergoing cesarean delivery, 30 women (0.8%) had hospital readmission due to infection. Increased risks of hospital readmission due to infection were seen with higher body mass index at admission (BMI) (aOR 1.05; 95%CI 1.01-1.10), operative time ≥60 min (aOR 2.52; 95%CI 1.13-5.58), and ruptured membrane (aOR 3.00; 95%CI 1.17-7.68). A lower risk of hospital readmission due to infection was seen with increasing maternal age (aOR 0.93; 0.87-0.996). CONCLUSION: Hospital readmission due to infection was associated with younger maternal age, higher BMI, operative time ≥60 min, and ruptured membrane.