Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Common reasons and risk factors for within 28 days acute hospital utilisations post colorectal cancer surgery (#436)

Bora Kim 1 , Judith Fethney 2 , Margaret-Ann Tait 3 , Claudia Rutherford 2 , Kate White 3
  1. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  2. School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia
  3. Cancer Care Research Unit, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

Aims

To examine the prevalence and common reasons for emergency presentation/hospital readmission within 28-days following colorectal cancer surgery and identify their possible predictors.

 

Methods

We analysed routinely collected de-identified data containing patient demographics, comorbidities, surgical procedures, and acute hospital utilisations from three major metropolitan hospitals in Sydney, NSW. Data for adult patients (>18 yrs) admitted to these hospitals for a colon/or rectum surgical procedure with concurrent colorectal cancer diagnosis between 1 January 2015 and 30 July 2020 were included. Prevalence and reasons for within 28-day post-surgical emergency presentations and hospital admissions were reported descriptively. Poisson regression of sociodemographic and clinical data was used to explore risk factors for emergency department (ED) presentations. Multivariable analysis was conducted with variables with p<0.1 in the Chi-Squared test.

 

Results

Analyses included data from 1653 patients; mean age 67 (range 19-98), male (n=945, 57%), colon cancers (n=1166, 71%), married (n=987, 60%), and having English as primary language (n=1233, 75%). 193 patients (12%) made 237 ED presentations: 155 patients (65%) made one, and 82 patients (35%) made more than one presentation. Half of ED presentations (n=106, 45%) were made within 10 days post-surgical discharge. Predominant reasons were gastrointestinal symptoms and surgical complications (n=100, 42%), infection or wound-related (n=60, 25%), and volume depletion and electrolyte imbalance (n=26, 11%). Of 1653 patients, 156 (9%) made 163 hospital admissions, with a median length of stay of 5 days (IQR 3-12). Multivariable analysis identified the following factors associated with ED presentation: stoma vs. no stoma: 0.71, 95% CI: 0.53,0.96; p=0.026) and pre-operative malnutrition vs no malnutrition: 0.51, 95% CI: 0.3,0.86; p=0.013).  

 

Conclusions

One in ten colorectal post-surgical patients had ED presentations within 28-days of hospital discharge. There may be opportunities to reduce such episodes through better infection control and nutritional support interventions.