Unplanned re-hospitalizations after colorectal surgery

Abstract

From 7 to 11% of patients undergoing colorectal surgery are re-hospitalized and this occurs mostly due to a post-operative complication. The consequences can be severe with a high morbidity and mortality rate compared to the index hospitalization. Early re-hospitalizations (< 5 days) are mainly due to septic complications and ileus, while late re-hospitalizations are mainly related to septic complications and dehydration caused by high stomal output. Prevention of re-hospitalizations requires a combination of preventive measures, screening for complications prior to discharge, close consultative follow-up or even telemedicine follow-up after discharge, and provision of information to the patient, family, and caregivers about warning signs that warrant medical attention. The challenge in managing re-hospitalizations is to avoid treatment delay for a severe complication at the index center, while protecting patients from avoidable re-hospitalizations if patients present with typical post-operative symptoms or emerging complications that are manageable outside the hospital setting.