Research Activities, November-December 2013
Oral antibiotics and bowel preparation reduce hospital stays and 30-day readmissions in patients undergoing colectomy procedures
Patient Safety and Quality
Surgical site infections (SSIs) complicate approximately 15 percent of colectomies (partial or total removal of the colon) and have been linked to increased hospital length of stay (LOS) as well as readmissions. A new study reveals that oral antibiotics and bowel preparations (OABPs) before colorectal surgery is associated with both shorter LOS and fewer 30-day readmissions, primarily because of fewer readmissions for SSIs.
The study included 8,180 patients, who underwent elective colorectal surgery between 2005 and 2009 in Veterans Administration hospitals. In the study, an OABP, whose use has waned in recent years, was prescribed to 3,575 of the 8,180 patients. SSIs occurred in 1,192 (14.6 percent) patients and significantly differed by bowel preparation category: OABP (8.6 percent), mechanical bowel preparation alone (19.5 percent), and no bowel preparation (18.6 percent). Thirty day readmission occurred in 1,161 (14.2 percent) patients, ranging from 12.7 percent for OABP, and 15.0 percent for mechanical preparation, to 16.1 percent for no preparation.
The researchers believe that efforts to improve adherence with use of OABP can improve the efficiency of care for colorectal surgery. This study was supported in part by AHRQ (T32 HS13852).
See "Oral antibiotic bowel preparation reduces length of stay and readmissions after colorectal surgery," by Galinan D. Toneva, B.S., Rhaiannon J. Deierhoi, M.P.H., Laura K. Altom, M.D., M.S.P.H., and others in the Journal of the American College of Surgeons 216, pp. 765-763, 2013.