A patient wakes up from anesthesia and breathes a sigh of relief to learn that the procedure was successful. Unfortunately, malpractice can arise not only in surgery, but also after surgery. This firm has taken on several cases involving post-operative errors in care, including failure to monitor.

Recently, a peer-reviewed study revealed how many patients experience unexpected complications and must be readmitted to a hospital. Alarmingly the study also revealed that patients that were seen by a different hospital were more at risk for dying soon thereafter.

You can read an abstract of the study here:

[Readmission destination and risk of mortality after major surgery: an observational cohort study](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60087-3/abstract)

Researchers examined data from more than 9 million Medicare patients who were readmitted within 30 days after undergoing any of 12 major surgical procedures between 2001 and 2011. Led by the University of Utah, it is the largest analysis of surgical patients of its kind.

From the data it was determined that following operations, between 5 and 22 percent of patients were readmitted, depending on the type of surgery. Between 66 and 83 percent of patients who had complications were readmitted to the same hospital where they had the original procedure. But some patients, particularly those who travel to have an operation performed, may not have the ability or opportunity to return to the same facility in the event of complications.

The study demonstrated that patients who went to a different hospital for their complications had a 26 percent increased risk for dying within 90 days. Better survival was consistent across all surgeries when patients returned to the same hospital. Specifically it ranged from a 44 percent decrease in risk for death for those who underwent pancreatectomy, to 13 percent for coronary artery bypass surgery. The study did point out that the results are observational and a randomized trial is needed to prove a causal link.

The issue is suspected to be continuity of care, which can be defined as a patient’s continuing relationship with an identified health care professional. Reflecting on the results, an author of the study suggested “every effort should be made to transfer surgical patients back within 24 hours to their original hospital for post-operative management.”

This blog post does not mean to suggest that the heightened risk for death illustrated by the study is always, or even usually, attributable to medical malpractice. It does, however, remind us that a proper response to complications from surgery is critical. Understanding what complication has arisen and how to appropriately respond is the duty of any subsequent treating physician, but apparently it is more successfully recognized and managed when ‘continuity of care’ exists.