Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery

Abstract

Background: Initial programmes of fast‐track open colonic surgery with a planned 2‐day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast‐track open colonic surgery programme with a planned hospital stay of 2 versus 3 days. Methods: The study included 541 consecutive colonic resections from one surgical department with a structured care programme, including well defined discharge criteria, between April 1997 and December 2005. The planned hospital stay was increased from 2 to 3 days from August 2004. All patients were examined 8 and 30 days after surgery. Results: Readmission rates fell from 20·1 per cent in 408 patients with a planned 2‐day hospital stay (period 1) to 11·3 per cent in 133 patients with a planned 3‐day hospital stay (period 2) (P < 0·020). Median length of primary hospital stay was 2 and 3 days, median stay after readmission was 5 and 5·5 days, and median (mean) total stay was 3 (5·6) and 3 (5·7) days in periods 1 and 2 respectively. The readmission rate in period 2 was lower because there were fewer readmissions for short‐term observation or social reasons. There was no difference in type and incidence of morbidity between the two periods. Conclusion: Readmission after fast‐track open colonic resection was reduced by planning discharge 3 instead of 2 days after surgery, with the same discharge criteria. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.