An analysis of unplanned readmissions after head and neck microvascular reconstructive surgery |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, University of Florida Jacksonville, Jacksonville, FL, USA;2. Department of Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy;1. Division of Allergic Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota;2. Division of Allergy and Immunology, Department of Pediatrics, Mayo Clinic, Rochester, Minnesota;3. Department of Pediatrics, University of Missouri–Kansas City, Faculty, Division of Allergy, Asthma, and Immunology, Children''s Mercy Hospital, Kansas City, Missouri;1. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;2. Radboudumc 3D Lab, Radboud University Medical Centre, Nijmegen, The Netherlands;1. Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy;2. Department of Cardiology, Medical University of Graz, Graz, Austria;1. Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts;2. Division of General Internal Medicine, Medical Service, Massachusetts General Hospital, Boston, Massachusetts;3. Mongan Institute for Health Policy, Massachusetts General Hospital and Partners HealthCare, Boston, Massachusetts;4. Department of Medicine, Harvard Medical School, Boston, Massachusetts;5. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts;6. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts;1. Diagnostic Clinic, Dentistry School, University of San Luis Potosi, San Luis Potosi, Mexico;2. Oral Microbiology, Pathology and Biochemical Laboratory, Dentistry School, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico |
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| Abstract: | The 30-day readmission rate is a highly scrutinized metric of quality surgical care, because readmission is costly and perceived to be avoidable with planning and patient education. Head and neck surgery patients generally have multiple risk factors for readmission, as readmitted patients are generally older, with more co-morbidities, lower socio-economic status, and a history of multiple emergency department visits and readmissions. A retrospective cohort study was implemented to determine the incidence and etiology of 30-day readmission after microvascular head and neck reconstructive surgery, focusing on social risk factors. Data were analyzed by χ2 test, analysis of variance, t-test, and logistic regression, with statistical significance set at P < 0.05. Of 209 patients included in this study, 35 (16.7%) had a 30-day readmission. Increased needs at discharge were associated with increased readmission, while other social risk factors were less significant for a readmission in this study. |
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| Keywords: | microvascular surgery readmissions rehospitalizations complications healthcare system quality metric |
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