Hospitals can predict high-risk surgical patients, reduce readmissions

Hospital physicians can predict which patients will experience post-surgical complications and, in turn, reduce unplanned readmissions, using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) predicted risk of major complications, a new study published in JAMA Surgery shows. 

Researchers studied 142,232 admissions in the ACS NSQIP registry for major noncardiac surgery and found that the 30-day readmission rate for patients with any post-discharge complication was about 78 percent. Inpatients who developed complications had a 12 percent readmission rate and hospitals readmitted patients who experienced no complications almost 5 percent of the time, according to the study.

Patients at high risk for major complications--a predicted risk of ACS NSQIP complication greater than 10 percent--were 10 times more likely to return to the hospital compared to patients at low risk for complications, researchers found. Patients with high and moderate risk complications had seven and four times more readmissions risk, respectively, the study concluded.

The ACS's Surgical Risk Calculator, an online tool, can now help healthcare professionals gauge patients' risk by entering basic data into the system, according to an article from the University of Rochester Medical Center. The physician can then make more educated decisions about patient care, said Laurent G. Glance, M.D., lead study author and professor in the Departments of Anesthesiology and Public Health Sciences at the University of Rochester School of Medicine and Dentistry.

"If a patient's predicted risk of complications is high, which we've shown puts them at greater risk of readmission, a physician might decide to move the patient to the intensive care unit or a step-down unit after surgery, as opposed to a regular hospital unit that manages less sick patients," she said. 

The predictions could also help hospitals prevent complications by adjusting staffing, such as assigning one nurse to monitor just two or three high-risk patients as opposed to eight, according to the article. Hospitals can add the complication predictions to a patient's electronic medical record so physicians can make patient care decisions throughout the surgical process and monitor high-risk patients after discharge, Glance said. 

To learn more:
- here's the study abstract
- read the article
- check out the ACS risk calculator