Among patients with PHS—defined as the transient period of health vulnerability following an acute illness due to physiologic stressors from the initial admission— 7.6% had to be readmitted to the hospital within 30 days of undergoing elective outpatient hernia surgery. By comparison, only 1.6% of non-PHS patients had to be readmitted following hernia surgery.
The new findings may also apply to elective plastic surgery patients. “I would hypothesize a similar effect, since there are similarities in the composition of patients undergoing elective hernias and elective plastic surgery. However, I do caution against generalizing the results,” says study author Anai Kothari, MD, resident in the Department of Surgery of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine in Chicago.
Also, 8.3% of PHS patients were admitted to the emergency department within 30 days of hernia surgery, compared with 4.3% of non-PHS hernia surgery patients.
The findings were presented at the 2015 Western Surgical Association meeting in Napa Valley, Calif.
The Loyola researchers analyzed records of 57,988 California patients who underwent hernia repair in 2011, including 1,332 patients who had PHS. Data sets came from the US Agency for Healthcare Research and Quality. Researchers focused on hernia repair because it is a common surgery performed at ambulatory surgery centers, community hospitals, and academic medical centers.
Among the PHS patients, the most common reason for their previous hospitalization was gastrointestinal problems (25.1%), followed by cardiovascular problems (12.3%), hip fractures and other injuries (8.2%), and pregnancy-related complications (7.1%), the study showed. The average length of time between their previous hospitalization and their elective hernia surgery was 48.7 days.
Loyola researchers are now doing a follow-up study to determine what measures hospitals could take to reduce the negative impact of PHS.