WP7.6 - Unplanned Re-admisisons - How are we doing; Phase 1 study

Abstract

Introduction
30-day unplanned re-admissions provide an indicator of performance in the NHS Framework. Average readmission rate is around 15 to 17%, however surgical re-admission is less published. Therefore, a study was set up to assess the factors influencing surgical re-admissions in a Tertiary Centre.

Methods
Retrospective study of prospectively collected data from the tertiary centre database including all ‘Unplanned Re-admissions’(URA) aged >15 years in general surgery between January and December 2022. URA <15 years old and to other surgical specialties were excluded. ANOVA test and descriptive statistics were used to analyse the data.

Results
289 (58%) of 498 readmissions were URA with 150 (52%) female and 139 (48%) male. 57 (19%) were aged 15-30 years, 121 (42%) 31-60 years, 109 (38%) 61-90 years and 2 > 90 years (Median age 54 years; p<0.05). 191 (66%) were from ED, 84 (29%) were GP referrals, 10 (3%) from clinics and 4 (2%) transferred from network. 178 (62%) URA were within 10 days of discharge, 72 (25%) between 11-20 days and 39 (13%) > 20 days (p < 0.05). The commonest cause of URA was biliary diseases (n = 40, 14%) followed by lower (n=32, 11%) and upper abdominal pain (n=17, 5%) and nonspecific abdominal pain (n=22, 7%). Other causes included appendicitis (n=8, 3%), pancreatitis (n=8, 3%), post-op complications (n=14, 5%) and obstruction (n=24, 8%).

Conclusions
URA significantly impacts health care provision and patients’ confidence. An initial study has identified reasons and patterns of re-admissions, the next phase involves analysing specific reasons to mitigate factors leading to URA.