Risk Factors Associated with Readmission Within 30 days Following Stoma Surgery: Development of a “Traffic Light” Prediction Model

ABSTRACT NUMBER: NESTAC MEDAL FOR MEDICAL STUDENTS_3

MAIN ABSTRACT TEXT

Introduction
Patients undergoing stoma surgery have higher risk for early readmission. Some patients may benefit from closer post-discharge surveillance to provide early detection of complications and timely intervention. However, there is a paucity of validated tools to identify those at higher risk of readmission. Here, we determine independent risk factors associated with readmission within 30 days of discharge following stoma surgery, attempt to validate previous predictive models and develop a novel prediction tool.

Methods
A retrospective review of 423 patients who underwent ileostomy or colostomy stoma formation at a UK tertiary colorectal centre (2019-2021). Univariate, multivariate and logistic regression analysis were used to analyse a large number of demographics and risk factors and the association with readmission.

Results
This study cohort included 220 ileostomy and 203 colostomy patients. 87 (20.6%) were readmitted within 30 days of discharge following index surgery. A large number of demographics were evaluated for association with readmission. Readmission was associated with chronic heart failure (p<0.05), post-operative stoma-specific complications (bleeding p=0.02; high-output stoma p=0.01) and those with a loop ileostomy (34.0% versus 18.6%; p=0.01). A previous predictive model (Iqbal et al.) was ineffective in this cohort therefore a simplified “traffic light” risk scoring system was developed and found to have improved discrimination.

Conclusion
Readmission following stoma formation is associated with key variables that potentially provide the means to triage, risk score and potentially predict readmissions. We found a novel and simplified scoring system may provide improved prediction.