The impact of reoperation following colorectal resection on postoperative mortality: LTP16

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Aim:This study aims to investigate the impact of postoperative surgical complications on mortality.Method:All adult patients undergoing elective and emergency colorectal resection in England were extracted from the Hospital Episode Statistics (HES) dataset between 2000 and 2008. This dataset containsprocedural, demographic and diagnosis information of all patients admitted to NHS hospitals in England. A major re-operation was defined as re-intervention for an intra-abdominal complication such as laparotomy on the index admission or upon readmission within 28 days of initial resection.Results:Between 2000 and 2008, 246 269 patients underwent elective or emergency colorectal resection in England. Of these, 12 336 (5.0%) patients required a major re-operation in the postoperative period. The overall 30-day in-hospital mortality was 7.8% (19102/246469). Those patients that required re-operation had increased postoperative mortality [re-operation 16.9% (2081/12336) no re-operation 7.3% (17021/234133), P < 0.001]. In multiple regression analysis, requirement for major postoperative re-operation significantly increased mortality [odds ration 3.00 (CI 2.83-3.17) P < 0.001].Conclusion:The need for return to surgery in the postoperative period significantly increased mortality. Quality improvement efforts aimed at improving patient care and reducing postoperative surgical complication may have a beneficial impact on mortality.

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