Rehospitalization Patterns After Gastrointestinal Cancer Hospitalizations


Key Points

  • Unplanned rehospitalization was more common after medical vs surgical index hospitalization.
  • Risk factors for rehospitalization differed between medical and surgical patients. 

In a study reported in the Journal of Oncology Practice, Manzano et al found that unplanned rehospitalization within 30 days after gastrointestinal (GI) cancer hospitalization was more likely after medical vs surgical index hospitalizations among older patients. Some risk factors for rehospitalization differed between medical and surgical patients.

Study Details

The retrospective cohort study used linked Texas Cancer Registry and Medicare claims data on 69,693 hospitalizations for 31,736 patients. Overall, 35% of patients were aged ≥ 80 years, 51% were female, and 71% were white.

Readmission Rates and Risk Factors

The unplanned readmission rate was 21.6% after medical hospitalizations vs 13.4% after surgical hospitalizations. Significant risk factors for readmission shared by medical and surgical patients included advanced disease stage, high comorbidity index, and emergency room visit and radiation therapy within 30 days before the index hospitalization.

Additional significant risk factors for rehospitalization after medical hospitalization included residence in the least affluent neighborhoods, other types of GI cancer vs colon cancer, unplanned index hospitalization, and hospital length of stay ≥ 7 days. Other risk factors for rehospitalization among surgical patients included age ≥ 80 years, dual eligibility for Medicare and Medicaid, recent prior surgery, and intensive care unit stay during index hospitalization.

The investigators concluded, “Unplanned readmissions among elderly patients with GI cancer are more common after medical hospitalizations compared with surgical hospitalizations. There are shared risk factors and unique risk factors for these hospitalizations that can inform policy, health-care delivery, and interventions to reduce readmissions.”  

The study was supported by the Texas Department of State Health Services and the Cancer Prevention Research Institute of Texas, Centers for Disease Control and Prevention’s National Program of Cancer Registries, and National Cancer Institute.

Joanna-Grace M. Manzano, MD, of the Department of General Internal Medicine at The University of Texas MD Anderson Cancer Center, is the corresponding author for the Journal of Oncology Practice article. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.