Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Predictors of 30-day Readmission After Hysterectomy

Rates after benign and malignant indications

Malignancy, perioperative complications, and prior abdominal surgery, including cesarean section, are significant risk factors for consequent 30-day readmission following index hysterectomy. This according to a cohort of 1,649 women who underwent a hysterectomy for either benign indications (n=1,009) or for malignancy (n=640). Researchers found:

• 6% of the study population were subsequently readmitted within 30 days (8.9% for malignancy vs 4.2% for benign).

• The most common reasons for readmission were gastrointestinal (38%) and infectious (34%) etiologies, with 11.6% having experienced a perioperative complication.

• Among women undergoing hysterectomy for benign indication, a history of a prior laparotomy, including cesarean section (aOR=2.12), as well as a perioperative complication (aOR=2.41), were both associated with 2-fold increased odds of readmission.

• Among women undergoing hysterectomy for malignancy, an American Society of Anesthesiologists Physical Status Classification of III or IV (aOR=1.92), a longer length of initial hospitalization, and an estimated blood loss >500 cc (aOR=3.29) were associated with higher odds of readmission.

Citation: Lee MS, Venkatesh KK, Growdon WB, Ecker JL, York-Best CM. Predictors of 30-day readmission following hysterectomy for benign and malignant indications at a tertiary care academic medical center. [Published online ahead of print December 16, 2015]. Am J Obstet Gynecol. doi: 10.1016/j.ajog.2015.11.037.