Risk factors for hospital readmission following staging surgery for endometrial cancer
Endometrial cancer is the most common gynecologic malignancy, with surgical staging being the primary treatment. Despite generally favorable outcomes, postoperative complications frequently lead to unplanned hospital re-admissions, adversely affecting patient well-being and healthcare resource utilization. This study aimed to identify factors associated with hospital readmission following staging surgery for endometrial cancer. A retrospective cohort study of women undergoing staging surgery for endometrial cancer conducted between January 2016 and December 2022 at a single tertiary center. The primary outcome was hospital re-admission within 30 days of surgery. Demographics, clinical, laboratory data and pre intra and postoperative data were collected from electronic records. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of readmission. Among 470 patients, 36 (7.7 %) were readmitted within 30 days. Multivariable analysis identified four independent risk factors for readmission: Intraoperative complications (OR 15.94; 95 % CI 3.22-78.88; p < 0.001), preoperative hemoglobin < 10 g/dL (OR 5.52; 95 % CI 1.23-24.81; p = 0.026), prior abdominal surgery (OR 3.26; 95 % CI 1.29-8.74; p = 0.012) and ASA physical status classification ≥ 3 (OR 3.17; 95 % CI 1.30-7.74; p = 0.011). Most causes of readmission were fever (30.5 %), pain (22.3 %), and bleeding (16.6 %), while surgical site infections accounted for 5.6 of readmitted patients. Prolonged hospitalization was more common among readmitted patients but was not an independent predictor. Our findings confirm that previous abdominal surgery, ASA physical status classification ≥3, and preoperative anemia independently predict 30-day readmission after endometrial cancer staging surgery. These findings underscore the importance of risk stratification, optimization of preoperative status and enhanced postoperative monitoring to reduce avoidable readmissions and improve patient outcomes.