Evaluation of Emergency Department Treat-and-Release Encounters after Major Gastrointestinal Surgery

Evaluation of Emergency Department Treat-and-Release Encounters after Major Gastrointestinal Surgery

Published: Aug 01, 2023
Publisher: Journal of Surgical Oncology, vol. 128, issue 2

Brian C. Brajcich

Julie K. Johnson

Jane L. Holl

Karl Y. Bilimoria

Meagan S. Ager

Jeanette Chung

Rachel Hae Soo Joung

Cassandra B. Iroz

David D. Odell

David J. Bentrem

Anthony D. Yang

Patricia D. Franklin

Jennifer M. Slota

Casey M. Silver

Ted Skolarus

Ryan P. Merkow

Background and Objectives

Emergency department (ED) utilization after gastrointestinal cancer operations is poorly characterized. Our study objectives were to determine the incidence of, reasons for, and predictors of ED treat-and-release encounters after gastrointestinal cancer operations.


Patients who underwent elective esophageal, hepatobiliary, gastric, pancreatic, small intestinal, or colorectal operations for cancer were identified in the 2015–2017 Healthcare Cost and Utilization Project State Inpatient and State Emergency Department Databases for New York, Maryland, and Florida. The primary outcomes were the incidence of ED treat-and-release encounters and readmissions within 30 days of discharge.


Among 51 527 patients at 406 hospitals, 4047 (7.9%) had an ED treat-and-release encounter, and 5573 (10.8%) had an ED encounter with readmission. In total, 40.7% of ED encounters were treat-and-release encounters. ED treat-and-release encounters were most frequently for pain (12.0%), device/ostomy complaints (11.7%), or wound complaints (11.4%). ED treat-and-release encounters predictors included non-Hispanic Black race/ethnicity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.12–1.37) and Medicare (OR 1.27, 95% CI 1.16–1.40) or Medicaid (OR 1.82, 95% CI 1.62–2.40) coverage.


ED treat-and-release encounters are common after major gastrointestinal operations, making up nearly half of postdischarge ED encounters. The reasons for ED treat-and-release encounters differ from those for ED encounters with readmissions.

How do you apply evidence?

Take our quick four-question survey to help us curate evidence and insights that serve you.

Take our survey