New findings presented at the 2009 Clinical Congress of the American College of Surgeons have revealed that readmission to a hospital after standard surgical treatment for colon cancer is far more common than suspected for elderly patients.
Results from the first study to determine nationwide readmission rates following colectomy [surgical removal of malignant disease and part of the colon] in the Medicare population revealed that nearly one in nine patients over the age of 65 was readmitted within 30 days.
The study also showed that readmission was strongly linked with mortality. Sixteen per-cent of the patients who were readmitted died within a year compared with only seven percent of patients who were not readmitted died. "We cannot say that because these patients were readmit-ted therefore they have higher rates of death. But we can say there is a remarkably strong associ-ation between readmission and mortality that deserves further study," according to David Yu Greenblatt, MD, MSPH, a resident in general surgery at the University of Wisconsin, Madison.
The study departed from the typical outcome analysis of surgical care, which examines such factors as immediate postoperative outcomes, overall mortality, or cancer-free survival. "Most surgeons have tended to think that readmission is not a terribly serious outcome. They treat the patient for whatever circumstance caused readmission and send them home. In recent years, as researchers have focused on health care costs, readmissions have generated more interest," Dr. Greenblatt explained. The Centers for Medicare and Medicaid is, in fact, requiring hospitals to track readmission rates for a number of medical conditions, such as congestive heart failure and pneumonia.
