Unplanned readmission after appendectomy.

BACKGROUND

Unplanned readmission of patients who undergo appendectomy is a relatively frequent occurrence. Our aim was to report the most common reasons and the predictors of unplanned readmission after appendectomy.

METHODS

The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing emergent and/or urgent appendectomy during 2012 to 2013. Multivariate regression analysis was performed to identify the predictors of unplanned readmission.

RESULTS

We evaluated a total of 46,960 patients who underwent appendectomy. Of these, 18.5% had perforated appendicitis. Overall, 1,755 (3.7%) of patients had an unplanned readmission. The most common reasons for readmission were intra-abdominal infection (27.3%), nonspecific abdominal pain (7.9%), and paralytic ileus (4.6%). Factors such as perforated appendicitis (adjusted odds ratio [AOR], 1.38; P < .01), preoperative sepsis (AOR, 1.30; P < .01), and dirty surgical wound (AOR, 1.91; P < .01) were associated with unplanned readmission.

CONCLUSIONS

Overall, 3.7% of patients who underwent emergent appendectomy had an unplanned readmission. Intra-abdominal infections and nonspecific abdominal pain are the most common reasons for readmission. Unplanned readmissions are predominantly related to postoperative complications and severity of disease.