Hospital Readmissions After Urological Surgical Procedures in France: A Nationwide Cohort Study over 3 Years

Abstract Background Identifying the predictive factors for hospital readmission is required to target preventive measures. Objective To assess the rate of surgical readmissions after a urological procedure and the risk factors associated with readmission. Design, setting, and participants Data from all hospitalizations between January 2010 and November 2012 in France, regarding planned urological surgeries, were retrieved from the national medical database. To limit interactions between recent hospitalizations and surgical interventions, we selected only patients who were not hospitalized during the 12 mo preceding the urological procedure. Outcome measurements and statistical analysis Primary outcome was the rate of readmissions within 30 d after urological surgery. The following risk factors for readmission were assessed: sex, age, diagnosis-related group, length of stay of initial hospitalization, type of hospitalization (conventional or day surgery), hospital volume activity, hospital volume for day surgery, and hospital status. Logistic regression multivariate analysis was used to assess risk factors. Results and limitations Overall, 419 787 patients were included among whom 77 241 patients (18.40%) were readmitted within the following 30 d. After multivariate analyses, male sex (odds ratio [OR]=1.84, confidence interval [CI] 95%: 1.81–1.88), high level of comorbidity (diagnosis-related group 3–4 vs 1–2: OR=2.14, CI 95%: 2.10–2.21), and initial management in a private hospital (private vs university hospital: OR=1.13, CI 95%: 1.11–1.16; private vs public general hospital: OR=1.21, CI 95%: 1.18–1.23) were associated with a higher risk of readmission within 30 d. Conclusions Reported readmission rate within 30 d after a planned a urological procedure was nearly 20%. Patient summary In this French national study, we investigated the readmission rate within 30 d after a planned urological procedure in a large French population and discovered it was nearly 20%.