Determinants Of Early Readmission After Elective Colectomy For Colon Cancer
Location
Lions Eye Building
Presentation Date
30-10-2025 11:00 AM
End Date
30-10-2025 1:00 PM
Description
Background: Hospital readmission is an established quality metric for colectomy, offering insight into patient outcomes as well as accounting for nearly $300 million in annual U.S. healthcare costs. The objective of this study is to evaluate the modifiable and unmodifiable risk factors associated with 30-day readmission following elective colectomy for colon cancer. An enhanced understanding of patient and treatment-specific determinants can inform decision-making to minimize morbidity and optimize resource stewardship.
Methods: We performed a six-year (2013-2018) retrospective cohort analysis of the American College of Surgeons' National Surgical Quality Improvement Program database of adult patients who underwent elective colectomy for Stage I-III colon cancer. Variables assessed included patient demographics, comorbidities, frailty index, operative approach, cancer stage, and recent chemotherapy. Multivariable logistic regression identified independent predictors of 30-day readmission.
Results: Of 21,025 eligible patients, 6,987 patients met inclusion criteria. Among this cohort, sex distribution was approximately equal (49.6% female, 50.4% male), and patients were largely 60 years of age or older (70.8%), White (79.4%), of higher ASA classification (58.5%), and underwent colectomy via laparoscopic approach (71.8%). Overall, the readmission rate was 10.0%. Upon multivariable analysis, 30-day readmission was independently associated with race (p=0.025), disseminated cancer (p=0.042), surgical approach (p=0.050), higher patient ASA classification (p=0.003), and use of chemotherapy within 90 days (p=0.001). The following variables failed to demonstrate significant association: age, sex, body mass index, frailty index, smoking status, mechanical bowel preparation, oral antibiotic bowel preparation, and cancer stage.
Conclusions: Race, ASA classification, recent chemotherapy treatment, surgical approach, and disseminated cancer status were found to be associated with increased short-term readmission rates following elective colectomy for colon cancer. Awareness of these increased risk factors - which are predominantly nonmodifiable - can guide the cost-benefit analysis of elective operations to mitigate risk of readmission and subsequent morbidity and systemic cost.
Recommended Citation
Solanky, Maansi, "Determinants Of Early Readmission After Elective Colectomy For Colon Cancer" (2025). Medical Student Research Poster Symposium. 50.
https://digitalscholar.lsuhsc.edu/sommrd/2025MSRD/session2/50
Abstract
Determinants Of Early Readmission After Elective Colectomy For Colon Cancer
Lions Eye Building
Background: Hospital readmission is an established quality metric for colectomy, offering insight into patient outcomes as well as accounting for nearly $300 million in annual U.S. healthcare costs. The objective of this study is to evaluate the modifiable and unmodifiable risk factors associated with 30-day readmission following elective colectomy for colon cancer. An enhanced understanding of patient and treatment-specific determinants can inform decision-making to minimize morbidity and optimize resource stewardship.
Methods: We performed a six-year (2013-2018) retrospective cohort analysis of the American College of Surgeons' National Surgical Quality Improvement Program database of adult patients who underwent elective colectomy for Stage I-III colon cancer. Variables assessed included patient demographics, comorbidities, frailty index, operative approach, cancer stage, and recent chemotherapy. Multivariable logistic regression identified independent predictors of 30-day readmission.
Results: Of 21,025 eligible patients, 6,987 patients met inclusion criteria. Among this cohort, sex distribution was approximately equal (49.6% female, 50.4% male), and patients were largely 60 years of age or older (70.8%), White (79.4%), of higher ASA classification (58.5%), and underwent colectomy via laparoscopic approach (71.8%). Overall, the readmission rate was 10.0%. Upon multivariable analysis, 30-day readmission was independently associated with race (p=0.025), disseminated cancer (p=0.042), surgical approach (p=0.050), higher patient ASA classification (p=0.003), and use of chemotherapy within 90 days (p=0.001). The following variables failed to demonstrate significant association: age, sex, body mass index, frailty index, smoking status, mechanical bowel preparation, oral antibiotic bowel preparation, and cancer stage.
Conclusions: Race, ASA classification, recent chemotherapy treatment, surgical approach, and disseminated cancer status were found to be associated with increased short-term readmission rates following elective colectomy for colon cancer. Awareness of these increased risk factors - which are predominantly nonmodifiable - can guide the cost-benefit analysis of elective operations to mitigate risk of readmission and subsequent morbidity and systemic cost.
Comments
Mentor: Dr. Valentine Nfonsam, Morehouse School of Medicine-Department of Surgery