Unplanned readmissions after hernia repair.

INTRODUCTION

Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR) rate. The main goal of our study was to analyze the UR following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR).

METHODS

A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021.

RESULTS

The overall incidence of UR was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR was postoperative complications (PC). The nature of the predominant complications varied among the three categories. The correlation between UR and PC (and risk factors for PC) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR, but not in a rise of PC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings.

CONCLUSION

Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the PC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France.