Hospital readmissions related to postoperative venous thromboembolism (VTE) after complex cancer surgery are still occurring well after 30 days, according to a new study published in JAMA: Surgery.
The analysis included 126,104 adult patients evaluated for the study who underwent a complex cancer operation from January 2016 to September 2016. Fifty-eight percent of patients were men, and the mean age was 65 years old. All data was from the Nationwide Readmissions Database.
Overall, the 30-, 90-, and 180-day VTE-linked readmission rates were 0.6%, 1.1%, and 1.7%, respectively. VTE was a primary diagnosis in 15.8% of deaths during readmission after complex cancer surgery.
Of the 1,331 patients readmitted for VTE within 90 days, 456 (34.3%) were readmitted to another hospital other than where the surgery was initially performed.
According to the authors, the median length of stay was five days, the median cost was $8,102, and the total cost of all VTE readmissions combined was $23.8 million.
The group found that, among those 1,331 patients, a total of 122 (9.2%) died during their readmission visit, while 83 (6.2%) were readmitted multiple times.
Independent factors associated with an increased risk of 90-day readmission included operation type, a high mortality risk, older age, the number of comorbidities and postoperative complications. Readmissions were more common among female patients.
“These results suggest that the burden of VTE after complex cancer surgery is underappreciated by registries focused on 30-day outcomes,” wrote lead author Saad Mallick, BS, a specialist at Aga Khan University in Pakistan, and colleagues. “Quality improvement efforts on the burden of VTE should ensure a longer follow-up period.”
Mallick et al. noted that their analysis had limitations.
“This was a retrospective analysis of administrative data, and therefore errors in coding are possible," they wrote. "It is possible that some of these readmissions were primarily due to causes other than VTE."
Read the full study here.