ArticlePerioperative medicine (London, England)2025
Refining postoperative quality metrics: risk factors for emergency department visits within 3 days after hemorrhoidectomy.
Article in Perioperative medicine (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVery early hospital revisits following hemorrhoidectomy, particularly within 3 days of discharge, may reflect preventable peri-discharge complications more accurately than traditional 30-day readmission rates. However, few studies have systematically examined risk factors associated with this short-term outcome under real-world conditions.
methodsWe conducted a retrospective cohort study of 662 patients who underwent conventional hemorrhoidectomy for grade III or IV hemorrhoids at Lotung Poh-Ai Hospital between 2021 and 2023. The primary outcome was return to the emergency department (ED) within 3 days of discharge. Clinical, operative, and postoperative variables were analyzed using multivariate logistic regression.
resultsOf 662 patients, 46 (6.95%) returned to the ED within 3 days. The most common presenting symptom was severe wound pain (78.3%). Multivariate analysis identified thrombosed hemorrhoids (adjusted odds ratio [aOR], 3.05; 95% CI, 1.56-5.96; p = 0.001) and use of ≥ 2 postoperative analgesics (aOR, 3.96; 95% CI, 1.99-7.84; p < 0.001) as independent predictors of early ED revisit. Other clinical and laboratory variables were not significantly associated.
conclusionsThis study is among the first to identify specific predictors of ED visits within 3 days after hemorrhoidectomy. The presence of thrombosed hemorrhoids and escalated analgesic use may signal patients at risk for very early unplanned revisits. These findings challenge reliance on 30-day readmission metrics and support 72-h revisit rates as a sensitive quality indicator for discharge appropriateness and perioperative care.
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