ArticleAnnals of medicine2025
A real-world study on the influence of unplanned reoperations on hospitalized patients using the diagnosis-related group.
Article in Annals of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Incidence and predictors of early and late reoperation after primary lumbar spine fusion: a 10-year retrospective cohort study of 1,356 patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- The impact of unplanned reoperation on clinical and economic outcomes among hospitalized surgical patients: a DRG-adjusted real-world retrospective cohort study.BMC health services research · 2026Article
- Predicting the causes of unplanned reoperations using an AI-based multimodal system: a multicentre, multidepartmental study based on EMRs.BMJ digital health & AI · 2026Article
- Identification and cause analysis on unplanned reoperations by text classification approach.Scientific reports · 2025Article
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Authors and funding
6 authors.
Funding
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Abstract
objectiveThe issue of unplanned reoperations poses significant challenges within healthcare systems, with assessing their impact being particularly difficult. The current study aimed to assess the influence of unplanned reoperations on hospitalized patients by employing the diagnosis-related group (DRG) to comprehensively consider the intensity and complexity of different medical services.
methodsA retrospective cohort study of surgical patients was conducted at a large tertiary hospital with two hospital districts employing data sourced from a DRG database. Hospital length of stay (LOS) and hospitalization costs were measured as the primary outcomes. Discharge to home was measured as the secondary outcome. Frequency matching based on DRG, regression modeling, subgroup comparison and sensitivity analysis were applied to evaluate the influence of unplanned reoperations.
resultsWe identified 20820 surgical patients distributed across 79 DRGs, including 188 individuals who underwent unplanned reoperations and 20632 normal surgical patients in the same DRGs. After DRG-based frequency matching, 564 patients (188 with unplanned reoperations, 376 normal surgical patients) were included. Unplanned reoperations led to prolonged LOS (before matching: adjusted difference, 12.05 days, 95% confidence interval [CI] 10.36-13.90 days; after matching: adjusted difference, 14.22 days, 95% CI 11.36-17.39 days), and excess hospitalization costs (before matching: adjusted difference, $4354.29, 95% CI: $3,817.70-$4928.67; after matching: adjusted difference, $5810.07, 95% CI $4481.10-$7333.09). Furthermore, patients who underwent unplanned reoperations had a reduced likelihood of being discharged to home (before matching: hazard ratio [HR] 0.27, 95% CI 0.23-0.32; after matching: HR 0.31, 95% CI 0.25-0.39). Subgroup analyses indicated that the outcomes across the various subgroups were mostly uniform. In high-level surgery subgroups (levels 3-4) and in relation to complex diseases (relative weight ≥ 2), the increase in hospitalization costs and LOS was more pronounce after unplanned reoperations. Similar results were observed with sensitivity analysis by propensity score matching and excluding short LOS.
conclusionsIncorporating the DRG allows for a more effective assessment of the influence of unplanned reoperations. In managing such reoperations, mitigating their influence, especially in the context of high-level surgeries and complex diseases, remains a significant challenge that requires special consideration.
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