August 29, 2017

Postop pain predicts readmissions, ED visits

By: Judy Mathias

Editor’s Note

Postoperative pain trajectories can identify patients at risk for 30-day readmissions and emergency department (ED) visits, and are not mediated by postdischarge complications, this study finds.

In this analysis of 211,231 surgical procedures (45.4% orthopedic, 37.0% general, and 17.6% vascular), the 30-day unplanned readmission rate was 10.8%, and the 30-day ED utilization rate was 14.2%.

Patients in the high-pain trajectories had the highest rates of readmissions and ED visits (14.4% and 16.3%, respectively).

Multivariate analysis found a dose-dependent increase in postdischarge readmissions and ED visits for pain-related diagnoses but not postdischarge complications.

Addressing pain control expectations before discharge may help reduce readmissions for patients in high-pain categories, the authors note.

Objective: We hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. Background: Surgical readmissions have few known modifiable predictors. Pain experienced by patients may reflect surgical complications and/or inadequate or difficult symptom management.

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