The Impact of Preoperative Risk Factors on Unplanned Readmission After Day Surgery: A Meta-Analysis

TL;DR

This study identifies key pre-surgery risk factors that increase the chance of unplanned hospital readmissions after day surgery, helping doctors improve patient care.

Contribution

A meta-analysis identifying specific preoperative risk factors linked to unplanned readmissions after day surgery.

Findings

Age ≥ 60 years significantly increases readmission risk.

Chronic diseases and general anesthesia are strongly associated with readmissions.

Bleeding disorders and complex surgery types also elevate readmission risk.

Abstract

Objective: This research seeks to explore and determine the principal pre-surgical risk elements associated with unplanned readmissions following day surgery, providing evidence-based guidance for clinical practice to optimize preoperative evaluations and reduce the incidence of readmissions. Background: As day surgery becomes increasingly common across global healthcare systems, ensuring effective postoperative recovery and preventing readmissions have become critical challenges. Numerous studies have explored the impact of various preoperative risk factors on postoperative readmissions. This study synthesizes existing evidence through a meta-analysis to identify the key preoperative factors associated with increased readmission risk. Methods: An extensive literature review was conducted across various databases, such as Web of Science, PubMed, CINAHL, Scopus, Embase, the Cochrane Library, and CNKI, to gather all relevant clinical research on pre-surgical risk elements for day surgery procedures, with studies included up to 15 January 2025. A structured analysis was undertaken, and the findings were integrated using a random-effects approach to assess the influence of key preoperative risk factors on subsequent readmissions in day surgery environments. Results: A total of 12 studies, involving 704,568 patients, were incorporated into the final analysis. The findings identified several preoperative factors that were significantly associated with an increased risk of postoperative readmission. These risk factors included: age ≥ 60 years (OR = 2.38, 95% CI: 1.74–3.26, p < 0.00001), ASA classification ≥ 3 (OR = 1.96, 95% CI: 1.61–2.38, p < 0.00001), presence of chronic diseases (OR = 11.78, 95% CI: 9.99–13.90, p < 0.00001), general anesthesia (OR = 2.42, 95% CI: 1.51–3.86, p = 0.0002), infection risk (OR = 1.68, 95% CI: 1.35–2.10, p < 0.00001), gender (OR = 2.45, 95% CI: 2.21–2.71, p < 0.00001), complex surgery type (OR = 2.83, 95% CI: 2.03–3.93, p < 0.00001), and bleeding disorders (OR = 1.82, 95% CI: 1.53–2.17, p < 0.00001). Conclusions: This study highlights several key preoperative risk factors associated with unexpected readmissions following day surgery. These factors include age, ASA classification, presence of chronic diseases, general anesthesia, infection risk, gender, complex surgery type, and bleeding disorders. These findings provide valuable insights for preoperative assessments. Clinicians should focus on these high-risk factors during preoperative assessment and management to minimize postoperative readmission rates and improve surgical safety and recovery outcomes for patients.

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