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Unplanned readmissions after hernia repair

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Abstract

Introduction

Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR30) rate. The main goal of our study was to analyze the UR30 following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR).

Methods

A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021.

Results

The overall incidence of UR30 was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR30 was postoperative complications (POC). The nature of the predominant complications varied among the three categories. The correlation between UR30 and POC (and risk factors for POC) was strong in GHR but was not in IVHR due to a ‘protective’ longer LOS in this subgroup. As the LOS has decreased over the last years, this has ‘mechanically’ resulted in an increase in the occurrence of UR30, but not in a rise of POC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings.

Conclusion

Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the POC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs’ and nurses’ shortage in France.

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Authors and Affiliations

  1. Service de chirurgie digestive, endocrinienne et générale, CHU de Limoges, Avenue Martin Luther King, 87042, Limoges Cedex, France

    N. Christou & M. Mathonnet

  2. Clinique de chirurgie digestive et endocrinienne (CCDE), institut des maladies de l’appareil digestif (IMAD), Hôtel Dieu, CHU de Nantes, Place Ricordeau, 44093, Nantes Cedex 1, France

    F. Drissi & J.-F. Gillion

  3. University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TH, UK

    D. N. Naumann

  4. Clinique des Noriets, 12 Rue des Noriets, 94400, Vitry-sur-Seine, France

    D. Blazquez

  5. Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d’Antony, 1, Rue Velpeau, 92160, Antony, France

    N. Christou, F. Drissi, D. N. Naumann, D. Blazquez, M. Mathonnet & J.-F. Gillion

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  1. N. Christou
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Contributions

NC conceived and designed the study. FD, DB, and JFG acquired the data. NC and JFG analyzed data. NC and JFG interpreted data. NC, FD, DB, DNN, MM, and JFG contributed to the writing of the manuscript and its critical revision. NC, FD, DB, DNN, MM, and JFG approved the final version of the manuscript.

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Correspondence to N. Christou.

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Christou, N., Drissi, F., Naumann, D.N. et al. Unplanned readmissions after hernia repair. Hernia 27, 1473–1482 (2023). https://doi.org/10.1007/s10029-023-02876-y

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