A national analysis of readmissions for wound healing complications following the repair of lower back,hip, and buttock pressure ulcers using the Nationwide Readmissions Database |
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| Affiliation: | 1. Department of Surgery, The University of Kansas School of Medicine – Wichita, Wichita, KS, USA;2. Department of Medical Education, The University of Kansas School of Medicine – Wichita, Wichita, KS, USA;1. Center for Advanced Medical Learning and Simulation (CAMLS), USF Health, University of South Florida, Tampa, FL, USA;2. Morsani College of Medicine, USF Health, University of South Florida, Tampa, FL, USA;3. Psychology Department, University of South Florida, Tampa, FL, USA;4. Medical Physics Department, Athens University Medical School, Athens, Greece;5. William Maul Measey Institute for Clinical Simulation and Patient Safety, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA;6. Eastern Virginia Medical School, Norfolk, VA, USA;1. Bhabha Atomic Research Centre Hospital, Mumbai, India;2. Institute of Orthopaedic and Traumatology, Madras Medical College, Chennai, India;3. Department of Surgery, Bhabha Atomic Research Centre, Mumbai, India;4. Department of Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India;1. Department of Surgery, University of California, San Francisco, USA;2. Department of Surgery, San Francisco VA Medical Center, USA;3. Department of Surgery, Jackson Memorial Hospital/University of Miami, USA |
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| Abstract: | BackgroundTraditionally, a 30-day postoperative period is used to assess outcomes in surgery. However, it is not clear if this is sufficient. Our study assessed readmissions and their risk factors following the surgical repair of pressure ulcers in a 90-day postoperative period.MethodsPatients with a pressure ulcer to the lower back, hip, and/or buttocks who underwent a pedicled or flap based wound operation were identified in the National Readmissions Database. We then analyzed risk factors for overall 0–90-day readmissions, early readmissions (0–30 days), and late-readmissions (31–90 days).Results3329 patients were identified, of which 154 (4.66%) had surgical wound-related readmissions. A majority of these occurred after 30 days (53.89%). 90% of patients with a surgical-wound related readmission were readmitted within 63 days of index procedure.ConclusionsThe traditional 30-day outcome period is not enough to properly assess outcomes in pressure ulcer surgery such as readmission. We demonstrate that a period of at least 10 weeks and perhaps the entire global 90-day postoperative period would be more appropriate to evaluate readmissions after ulcer repair. |
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| Keywords: | Pressure ulcers Pressure ulcer surgery Surgical outcomes Surgical readmissions National readmissions database |
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