Readmissions and Emergency Room Visits Following Outpatient and Inpatient Herniorrhaphies
Abstract
Background: Hospital readmissions following abdominal wall hernia repairs (HR) are recognized sources of additional morbidity and costs. Large-scale studies focus primarily on readmissions and do not capture emergency department visits (EDV), time-wise stratification of post-operative encounters, or outpatient HR. We aimed to determine the incidence, timing, and primary reasons for EDVs and readmissions by linking state-level databases.
Methods: Patients who underwent HR in Maryland in 2016-2017 were identified in linked state-level databases, covering 95% of all HR. Encounters were grouped by postoperative timing and admitting diagnoses. Predictors of postoperative encounters were determined.
Results: Of 26,215 patients undergoing HR (87.5% outpatient, 48.7% inguinal), 5,802 (22.1%) had at least one postoperative encounter (4,186 EDV, 1,415 readmissions). EDV comprised 81.0% (419) of encounters within the first 48 hours. Top reasons for EDV were urinary disorders (24.1%, 10.6% and 4.0% on postoperative days (PODs) 0-2, 3-7, and 8-30, respectively), pain (18.1%, 24.9%, 14.4%), and GI complaints (10.5%, 9.9%, 3.4%). Readmissions mainly occurred for GI complaints (15.3%, 19.9%, 6.9%), local surgical site infection (SSI) (5.1%, 15.5%, 26.8%), and respiratory complications (8.2%, 6.6%, 4.1%). The most significant predictors of postoperative encounters were non-private insurance and African American origin.
Discussion: ED visits and readmissions after herniorrhaphy remain major…
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