Head & neck · 2018
Thirty-day readmission in patients undergoing head and neck microvascular reconstruction.
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Graboyes Evan M, Schrank Travis P, Worley Mitchell L, Momin Suhael R, Day Terry A, Huang Andrew T
Аннотация
BACKGROUND: Characteristics of 30-day unplanned readmissions after head and neck microvascular reconstruction remain poorly understood.
METHODS: We conducted a retrospective cohort of patients who underwent head and neck microvascular reconstruction between 2010 and 2015.
RESULTS: The 30-day unplanned readmission rate was 13.0% (64/493). The most common readmission diagnoses were dehiscence, surgical site infection, or fistula (45.3%; n = 29). Of the readmissions, 46.9% (30/64) occurred within 7 days of discharge from the hospital. Risk factors for readmission on multivariable analysis included body mass index (BMI) < 21 kg/m (odds ratio [OR] 2.47; 95% confidence interval [CI] 1.36-4.47), primary site of oropharynx (OR 1.66; 95% CI 1.17-6.06), hypopharynx/larynx (OR 3.66; 95% CI 1.70-7.88), or sinonasal/skull base (OR 4.07; 95% CI 1.43-11.55), and fistula during the index hospitalization (OR 2.98; 95% CI 1.22-7.24).
CONCLUSION: More than 1 in 10 patients undergoing head and neck microvascular reconstruction has a 30-day unplanned readmission, most commonly related to wound complications. Further efforts are needed to determine optimal 30-day unplanned readmission reduction strategies.
METHODS: We conducted a retrospective cohort of patients who underwent head and neck microvascular reconstruction between 2010 and 2015.
RESULTS: The 30-day unplanned readmission rate was 13.0% (64/493). The most common readmission diagnoses were dehiscence, surgical site infection, or fistula (45.3%; n = 29). Of the readmissions, 46.9% (30/64) occurred within 7 days of discharge from the hospital. Risk factors for readmission on multivariable analysis included body mass index (BMI) < 21 kg/m (odds ratio [OR] 2.47; 95% confidence interval [CI] 1.36-4.47), primary site of oropharynx (OR 1.66; 95% CI 1.17-6.06), hypopharynx/larynx (OR 3.66; 95% CI 1.70-7.88), or sinonasal/skull base (OR 4.07; 95% CI 1.43-11.55), and fistula during the index hospitalization (OR 2.98; 95% CI 1.22-7.24).
CONCLUSION: More than 1 in 10 patients undergoing head and neck microvascular reconstruction has a 30-day unplanned readmission, most commonly related to wound complications. Further efforts are needed to determine optimal 30-day unplanned readmission reduction strategies.