A multicentre study to determine the incidence, demographics, aetiology and outcomes of 6-day emergency readmission following day-case endoscopy.

Background: Emergency readmission after elective procedures is a quality indicator of healthcare delivery, but data for endoscopy are limited.

Objectives: Using hospital episode statistics (HES) registration systems and a multicentre audit to describe outcomes of emergency readmission following elective endoscopy.

Methods: Emergency readmissions (April 2008-2009) within 6 days of an elective day-case upper-GI endoscopy (UE) and lower GI endoscopy (LE) were subjected to a multicentre retrospective audit (north-west of England) following the identification of cases from routinely coded hospital administrative data from HES.

Results: Of 29 868 day cases, there were 235 readmissions, of which 147 (63%) were endoscopy related. The overall endoscopy readmission rate was 0.5% and the highest for therapeutic UE (1.74%; P=0.0001). The rates for therapeutic LE, diagnostic UE and LE were 0.6, 0.5 and 0.4%, respectively. The incidence of readmission was 0.2% because of cardiorespiratory event, 0.14% for symptoms and 0.08, 0.03, 0.02 and 0.016%, respectively, for bleeding, perforation, obstruction and nonrespiratory sepsis. Management was simple observation in 84.4%, intravenous antibiotics in 7.5%, surgery in 4.8% and repeat endoscopy in 2.7%. Although 24.5% were short-stay discharges, the mean hospital stay was 8.2 days. All-cause 30-day mortality was low at 0.06%, but was considerably higher in readmitted patients at 6.8% (P=0.0001).

Conclusion: Novel insights into readmission rates can be gained following endoscopy using a combination of commercial analytical tools to examine HES data to identify eligible readmitted cases; multicentred patient-level audit readmission rates varied predictably across procedure types with cardiorespiratory events, the major cause. The risk of mortality in readmitted patients was significant.