Analysis of risk factors for unplanned readmission within 30 d after discharge in patients with colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Wengang , ZHONG Sijia , PAN Jianguo , DONG Ming ,  WANG Kewei

Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang 110001, P. R. China;

Corresponding?author：

WANG Kewei, Email: kwwang@cmu.edu.cn

Keywords：

colorectal cancer; unplanned readmission; complications; risk factor; perioperative period

DOI：

10.7507/1007-9424.202510045

Video：

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Objective To explore the risk factors for unplanned readmission within 30 d after discharge in patients with colorectal cancer (CRC). Methods Clinical data were retrospectively collected from patients who underwent radical surgery for CRC in the Department of Gastrointestinal Surgery, The First Hospital of China Medical University, from January 2020 to December 2023. The data included demographic characteristics, Nutritional Risk Screening 2002 score, tumor characteristics, preoperative comorbidities, surgical and postoperative recovery status, and pre-discharge laboratory indicators. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for unplanned readmission within 30 days after discharge. Results A total of 1 080 patients were included in this study. The rate of unplanned readmission within 30 d after discharge was 4.3% (46/1 080). The top three causes of unplanned readmission were postoperative ileus [50.0% (23/46)], infected peritoneal effusion [26.1% (12/46)], and gastrointestinal bleeding [8.7% (4/46)]. Multivariate analysis showed that rectal cancer [OR (95%CI)=2.773 (1.374, 5.594), P=0.004], stoma creation [OR (95%CI)=2.261 (1.184, 4.391), P=0.013], and preoperative hypoalbuminemia [OR (95%CI)=2.039 (1.097, 3.787), P=0.024] were independent risk factors for unplanned readmission within 30 d after discharge, while shorter time to first postoperative oral intake was a protective factor [OR (95%CI)=0.881 (0.99, 0.971), P=0.011]. Conclusions This study suggests that patients with rectal cancer, those underwent stoma creation, those with preoperative hypoalbuminemia, and those with delayed postoperative oral intake are at higher risk of unplanned readmission within 30 days after discharge. Perioperative management should be strengthened, including preoperative nutritional support, early postoperative oral intake, and stoma care, to reduce the risk of readmission.

Citation： WANG Wengang, ZHONG Sijia, PAN Jianguo, DONG Ming, WANG Kewei. Analysis of risk factors for unplanned readmission within 30 d after discharge in patients with colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(3): 350-353. doi: 10.7507/1007-9424.202510045 Copy

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
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3.	Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
4.	Xue Y, Li S, Guo S, et al. Evaluation of the advantages of robotic versus laparoscopic surgery in elderly patients with colorectal cancer. BMC Geriatr, 2023, 23(1): 105. doi: 10.1186/s12877-023-03822-4.
5.	Qu N, Li T, Zhang L, et al. Risk factors for unplanned 31-day readmission after surgery for colorectal cancer patients: a meta-analysis. BMC Gastroenterol, 2025, 25(1): 285. doi: 10.1186/s12876-025-03872-5.
6.	Xu W, Wells CI, McGuinness M, et al. Characterising nationwide reasons for unplanned hospital readmission after colorectal cancer surgery. Colorectal Dis, 2023, 25(5): 861-871.
7.	Clausen J, Hansen HF, Walbech JS, et al. Incidence and clinical predictors of 30-day emergency readmission after colorectal cancer surgery—a nationwide cohort study. Colorectal Dis, 2023, 25(2): 222-233.
8.	Alyabsi MS, Alqarni AH, Almutairi LM, et al. The 30-day hospital readmission and mortality after surgery in colorectal cancer patients. BMC Gastroenterol, 2022, 22(1): 434. doi: 10.1186/s12876-022-02516-2.
9.	D’Souza J, Eglinton T, Frizelle F. Readmission prediction after colorectal cancer surgery: a derivation and validation study. PLoS One, 2023, 18(6): e0287811. doi: 10.1371/journal.pone.0287811.
10.	Our? S, Ferreira MP, Albergaria D, et al. Loop ileostomy in rectal cancer surgery: factors predicting reversal and stoma related morbidity. Langenbecks Arch Surg, 2021, 406(3): 843-853.
11.	McLean C, Mocanu V, Birch DW, et al. Hypoalbuminemia predicts serious complications following elective bariatric surgery. Obes Surg, 2021, 31(10): 4519-4527.
12.	Deng Y, Fang Y, Li H, et al. A preoperative whey protein and glucose drink before hip fracture surgery in the aged improves symptomatic and metabolic recovery. Asia Pac J Clin Nutr, 2020, 29(2): 234-238.
13.	de Carvalho CS, Silva TH, André JCS, et al. Preoperative fasting abbreviation with whey protein reduces the occurrence of postoperative complications in patients with head and neck cancer: a randomized clinical trial. Nutr Clin Pract, 2021, 36(3): 665-672.
14.	Wang Z, Peng W, Zhang J. The effect of early enteral nutrition under the eras model on gastrointestinal and immune function recovery in patients undergoing gastric tumor surgery. Ann Ital Chir, 2024, 95(6): 1147-1154.
15.	Law JH, Lau J, Pang NQ, et al. Preoperative quality of life and mental health can predict postoperative outcomes and quality of life after colorectal cancer surgery. Medicina (Kaunas), 2023, 59(6): 1129. doi: 10.3390/medicina59061129.
16.	Tatar C, Benlice C, Delaney CP, et al. Modified frailty index predicts high-risk patients for readmission after colorectal surgery for cancer. Am J Surg, 2020, 220(1): 187-190.
17.	Chen HP, Chen CI, Song LC, et al. Higher hospital frailty risk score is predictive of 90-day readmission after minimally invasive colorectal cancer surgery: a national readmission database analysis. Am J Cancer Res, 2025, 15(5): 2208-2221.
18.	Oh EG, Oh S, Cho S, et al. Predicting readmission among high-risk discharged patients using a machine learning model with nursing data: retrospective study. JMIR Med Inform, 2025, 13: e56671. doi: 10.2196/56671.
19.	Jeyanthi P, Gulothungan G, Vinoth Kumar V, et al. Enhancing postoperative care with telemedicine and remote monitoring for improved recovery and patient safety. Int J Surg, 2024, 110(12): 8205-8206.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. 郭蘭偉, 張興龍, 蔡林, 等. 全球結直腸癌流行和防控現狀. 中華腫瘤雜志, 2024, 46(1): 57-65.
3. Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
4. Xue Y, Li S, Guo S, et al. Evaluation of the advantages of robotic versus laparoscopic surgery in elderly patients with colorectal cancer. BMC Geriatr, 2023, 23(1): 105. doi: 10.1186/s12877-023-03822-4.
5. Qu N, Li T, Zhang L, et al. Risk factors for unplanned 31-day readmission after surgery for colorectal cancer patients: a meta-analysis. BMC Gastroenterol, 2025, 25(1): 285. doi: 10.1186/s12876-025-03872-5.
6. Xu W, Wells CI, McGuinness M, et al. Characterising nationwide reasons for unplanned hospital readmission after colorectal cancer surgery. Colorectal Dis, 2023, 25(5): 861-871.
7. Clausen J, Hansen HF, Walbech JS, et al. Incidence and clinical predictors of 30-day emergency readmission after colorectal cancer surgery—a nationwide cohort study. Colorectal Dis, 2023, 25(2): 222-233.
8. Alyabsi MS, Alqarni AH, Almutairi LM, et al. The 30-day hospital readmission and mortality after surgery in colorectal cancer patients. BMC Gastroenterol, 2022, 22(1): 434. doi: 10.1186/s12876-022-02516-2.
9. D’Souza J, Eglinton T, Frizelle F. Readmission prediction after colorectal cancer surgery: a derivation and validation study. PLoS One, 2023, 18(6): e0287811. doi: 10.1371/journal.pone.0287811.
10. Our? S, Ferreira MP, Albergaria D, et al. Loop ileostomy in rectal cancer surgery: factors predicting reversal and stoma related morbidity. Langenbecks Arch Surg, 2021, 406(3): 843-853.
11. McLean C, Mocanu V, Birch DW, et al. Hypoalbuminemia predicts serious complications following elective bariatric surgery. Obes Surg, 2021, 31(10): 4519-4527.
12. Deng Y, Fang Y, Li H, et al. A preoperative whey protein and glucose drink before hip fracture surgery in the aged improves symptomatic and metabolic recovery. Asia Pac J Clin Nutr, 2020, 29(2): 234-238.
13. de Carvalho CS, Silva TH, André JCS, et al. Preoperative fasting abbreviation with whey protein reduces the occurrence of postoperative complications in patients with head and neck cancer: a randomized clinical trial. Nutr Clin Pract, 2021, 36(3): 665-672.
14. Wang Z, Peng W, Zhang J. The effect of early enteral nutrition under the eras model on gastrointestinal and immune function recovery in patients undergoing gastric tumor surgery. Ann Ital Chir, 2024, 95(6): 1147-1154.
15. Law JH, Lau J, Pang NQ, et al. Preoperative quality of life and mental health can predict postoperative outcomes and quality of life after colorectal cancer surgery. Medicina (Kaunas), 2023, 59(6): 1129. doi: 10.3390/medicina59061129.
16. Tatar C, Benlice C, Delaney CP, et al. Modified frailty index predicts high-risk patients for readmission after colorectal surgery for cancer. Am J Surg, 2020, 220(1): 187-190.
17. Chen HP, Chen CI, Song LC, et al. Higher hospital frailty risk score is predictive of 90-day readmission after minimally invasive colorectal cancer surgery: a national readmission database analysis. Am J Cancer Res, 2025, 15(5): 2208-2221.
18. Oh EG, Oh S, Cho S, et al. Predicting readmission among high-risk discharged patients using a machine learning model with nursing data: retrospective study. JMIR Med Inform, 2025, 13: e56671. doi: 10.2196/56671.
19. Jeyanthi P, Gulothungan G, Vinoth Kumar V, et al. Enhancing postoperative care with telemedicine and remote monitoring for improved recovery and patient safety. Int J Surg, 2024, 110(12): 8205-8206.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of risk factors for unplanned readmission within 30 d after discharge in patients with colorectal cancer

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