The Frequency and Indications for Hospital Readmissions after Abdominal Hysterectomies in a Regional Hospital in Hong Kong

Abstract

Objectives: To determine the frequency of emergency readmission within 28 days of abdominal hysterectomy, and to identify the indications and risk factors for such readmissions and explore feasible interventions to avoid them.
Methods: The study took place in the Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong. Hospital records of patients having emergency readmission within 28 days after abdominal hysterectomy performed in our unit between January 2004 and December 2009 were retrieved and analysed.
Results: Over the study period, 1823 patients underwent abdominal hysterectomy in our unit, of whom 67 had unscheduled readmissions within 28 days of discharge. The overall readmission rate was 3.7%. The readmitted group had a mean age of 52 years, though the majority were aged 40 to 49 years. Age of 70 years or more was a risk factor for readmission. Per-vaginal bleeding / vault haematoma was the most common reason for readmission, accounting for 26.9%. No statistically significant differences were found between those readmitted and a group of randomly selected controls with respect to mean age, intra-operative blood transfusions, intra-operative blood loss, nature of the operation (elective / emergency), type of operation (general / oncological), duration of the operation, training level of the surgeon, postoperative length of stay, co-morbidity scores, and previous abdominal surgery.

Conclusion: The emergency readmission rate after abdominal hysterectomies in our unit was 3.7% and the most common cause was per-vaginal bleeding / vault haematoma. Age of 70 years or older was a significant risk factor.