Unplanned readmissions after hernia repair

Club-Hernie Members; N. Christou; F. Drissi; D. N. Naumann; D. Blazquez; M. Mathonnet; J.-F. Gillion

doi:10.1007/s10029-023-02876-y

Unplanned readmissions after hernia repair

Club-Hernie Members
, N. Christou^*
, F. Drissi
, D. N. Naumann
, D. Blazquez
, M. Mathonnet
, J.-F. Gillion

^*Corresponding author for this work

Inflammation and Ageing

Research output: Contribution to journal › Article › peer-review

Abstract

INTRODUCTION: Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR₃₀) rate. The main goal of our study was to analyze the UR₃₀ following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR).

METHODS: A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021.

RESULTS: The overall incidence of UR₃₀ was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR₃₀ was postoperative complications (P_OC). The nature of the predominant complications varied among the three categories. The correlation between UR₃₀ and POC (and risk factors for P_OC) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR₃₀, but not in a rise of P_OC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings.

CONCLUSION: Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the P_OC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France.

Original language	English
Pages (from-to)	1473-1482
Number of pages	10
Journal	Hernia: the journal of hernias and abdominal wall surgery
Volume	27
Issue number	6
Early online date	25 Oct 2023
DOIs	https://doi.org/10.1007/s10029-023-02876-y
Publication status	Published - Dec 2023

Bibliographical note

Keywords

Humans
Herniorrhaphy/adverse effects
Prospective Studies
Patient Readmission
Hernia, Ventral/surgery
Incisional Hernia/surgery
Postoperative Complications/epidemiology
Hernia, Inguinal/complications
Risk Factors
Length of Stay
Retrospective Studies

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10.1007/s10029-023-02876-y

Cite this

@article{3feac064108541a2ac198035b3429c70,

title = "Unplanned readmissions after hernia repair",

abstract = "INTRODUCTION: Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR30) rate. The main goal of our study was to analyze the UR30 following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR).METHODS: A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021.RESULTS: The overall incidence of UR30 was 1.32\%. This included 160/18,042 (0.87\%) for GHR, 41/4012 (1.02\%) for PVHR, and 145/3754 (3.86\%) for IVHR. The leading cause of UR30 was postoperative complications (POC). The nature of the predominant complications varied among the three categories. The correlation between UR30 and POC (and risk factors for POC) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR30, but not in a rise of POC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings.CONCLUSION: Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the POC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France.",

keywords = "Humans, Herniorrhaphy/adverse effects, Prospective Studies, Patient Readmission, Hernia, Ventral/surgery, Incisional Hernia/surgery, Postoperative Complications/epidemiology, Hernia, Inguinal/complications, Risk Factors, Length of Stay, Retrospective Studies",

author = "\{Club-Hernie Members\} and N. Christou and F. Drissi and Naumann, \{D. N.\} and D. Blazquez and M. Mathonnet and J.-F. Gillion",

note = "{\textcopyright} 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.",

year = "2023",

month = dec,

doi = "10.1007/s10029-023-02876-y",

language = "English",

volume = "27",

pages = "1473--1482",

journal = "Hernia: the journal of hernias and abdominal wall surgery ",

issn = "1265-4906",

publisher = "Springer",

number = "6",

}

TY - JOUR

T1 - Unplanned readmissions after hernia repair

AU - Club-Hernie Members

AU - Christou, N.

AU - Drissi, F.

AU - Naumann, D. N.

AU - Blazquez, D.

AU - Mathonnet, M.

AU - Gillion, J.-F.

PY - 2023/12

Y1 - 2023/12

N2 - INTRODUCTION: Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR30) rate. The main goal of our study was to analyze the UR30 following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR).METHODS: A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021.RESULTS: The overall incidence of UR30 was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR30 was postoperative complications (POC). The nature of the predominant complications varied among the three categories. The correlation between UR30 and POC (and risk factors for POC) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR30, but not in a rise of POC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings.CONCLUSION: Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the POC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France.

AB - INTRODUCTION: Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR30) rate. The main goal of our study was to analyze the UR30 following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR).METHODS: A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021.RESULTS: The overall incidence of UR30 was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR30 was postoperative complications (POC). The nature of the predominant complications varied among the three categories. The correlation between UR30 and POC (and risk factors for POC) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR30, but not in a rise of POC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings.CONCLUSION: Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the POC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France.

KW - Humans

KW - Herniorrhaphy/adverse effects

KW - Prospective Studies

KW - Patient Readmission

KW - Hernia, Ventral/surgery

KW - Incisional Hernia/surgery

KW - Postoperative Complications/epidemiology

KW - Hernia, Inguinal/complications

KW - Risk Factors

KW - Length of Stay

KW - Retrospective Studies

U2 - 10.1007/s10029-023-02876-y

DO - 10.1007/s10029-023-02876-y

M3 - Article

C2 - 37880418

SN - 1265-4906

VL - 27

SP - 1473

EP - 1482

JO - Hernia: the journal of hernias and abdominal wall surgery

JF - Hernia: the journal of hernias and abdominal wall surgery

IS - 6

ER -

Unplanned readmissions after hernia repair

Abstract

Bibliographical note

Keywords

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