What Drives Readmission After CRC Surgery?

TOPLINE:

Almost 12% of patients with colorectal cancer (CRC) had unplanned readmissions within 31 days after surgery. Multiple risk factors were identified, including older age, comorbidities, advanced tumor stage, postoperative complications, and tumor location in the rectum, whereas female sex emerged as a protective factor.

METHODOLOGY:

• The high rate of unplanned readmissions within 31 days after CRC surgery poses a significant challenge and burden on patients and healthcare systems, but the identified risk factors for these readmissions vary across the literature.
• Researchers conducted systematic literature searches of eight databases up to January 2025 and performed a meta-analysis of 15 studies (13 cohort and two case-control studies) to investigate the incidence and risk factors for unplanned readmissions within 31 days after CRC surgery.
• They analyzed data of 693,917 patients with an endoscopic or pathologic diagnosis of CRC who underwent surgery, of whom 63,906 had unplanned readmissions.
• The overall quality of the included studies ranged from moderate to high, with the Newcastle-Ottawa Scale classifying 73% as high-quality.

TAKEAWAY:

• All 15 studies investigated the incidence of unplanned readmissions within 31 days following CRC surgery, yielding an overall rate of 11.73%.
• The risk factors associated with unplanned readmissions post-CRC surgery included older age (odds ratio [OR], 1.13; P = .01), higher Charlson Comorbidity Index score (OR, 1.27; P < .001), blood transfusion (OR, 1.24; P =.001), more invasive surgical approaches (OR, 1.22; P =.04), postoperative complications (OR, 1.87; P = .0004), and longer length of hospital stay (OR, 1.65; P < .001).
• Patients with tumor stages ≥ III had an increased risk for unplanned readmissions (OR, 2.01; P < .001), as did those with a tumor site in the rectum (OR, 1.64; P = .002) and stoma creation (OR, 1.70; P = .03).
• Women had a lower risk for unplanned readmissions than men (OR, 0.85; P < .001).

IN PRACTICE:

“The occurrence of postoperative [unplanned readmission] is the result of multiple contributing factors; therefore, healthcare providers need to systematically assess patient risks and develop targeted intervention strategies,” the authors wrote. “By establishing risk alert systems, optimizing perioperative management protocols, and implementing individualized interventions, the incidence of postoperative [unplanned readmission] can be effectively reduced, thereby improving short-term outcomes and enhancing overall healthcare quality.”

SOURCE:

This study, led by Nan Qu, Shanxi University of Chinese Medicine in Jinzhong, China, was published online in BMC Gastroenterology.

LIMITATIONS:

Researchers searched only four Chinese and four English databases, which may have led to the omission of relevant studies. The differences in study design may have introduced confounding factors. Additionally, some risk factors were analyzed using fewer than 10 studies.

DISCLOSURES:

This study received no funding. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.