Evidence map›Paper›PMID 28840472›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017

Thirty-Day Hospital Readmission After Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis for Chronic Ulcerative Colitis at a High-Volume Center.

Nicholas P McKenna, Kellie L Mathis, Mohammad Khasawneh, Omair Shariq, Eric J Dozois, David W Larson, Amy L Lightner

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Nicholas P McKennaDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Kellie L MathisDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.
Mohammad KhasawnehDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Omair ShariqDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Eric J DozoisDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.
David W LarsonDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.
Amy L LightnerDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA. Lightner.amy@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIleal pouch anal anastomosis (IPAA) is associated with a high 30-day hospital readmission rate. Risk factors and etiology of readmission remain poorly defined. We sought to determine the 30-day hospital readmission rate following IPAA at a high-volume center and identify any modifiable perioperative factors.

methodsA retrospective review of all patients undergoing two- or three-stage IPAA for chronic ulcerative colitis at our institution between 2002 and 2013 was performed. Analysis was performed on rate of readmission, readmission diagnosis, intervention performed upon readmission, and risk factors for readmission.

resultsThirty-day primary and secondary readmission rates after IPAA were 20.3% (n = 185) and 2.1% (n = 19), respectively. The leading etiologies for readmission included partial small bowel obstruction/ileus (n = 52, 21.9%), pelvic sepsis (n = 43, 18.1%), dehydration (n = 42, 17.7%), and venous thromboembolism (n = 31, 13.1%). While the majority of readmissions were managed medically (n = 119, 65.4%), 19.2% (n = 35) required radiologic intervention and 15.3% (n = 28) required a return to the operating room. On univariate analysis, younger age (p = 0.03) and female sex (p = 0.04) had a significantly increased risk of readmission. On multivariable analysis, BMI ≥ 30 (OR 0.51; 95% CI, 0.25-0.97, p = 0.04) was protective of readmission.

conclusionsThirty-day hospital readmission following IPAA remains a common problem. Preventable etiologies of readmission include dehydration and venous thromboembolism (VTE). Future quality improvement efforts should focus on education regarding stoma output and extended VTE prophylaxis to decrease hospital readmission rates following IPAA.

Indexed as

Patient ReadmissionPostoperative ComplicationsAdultColitis, UlcerativeColonic PouchesFemaleHospitalsHumansMaleMinnesotaProctocolectomy, RestorativeRetrospective StudiesRisk FactorsIPAAReadmissionUlcerative colitis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.