An analysis of unplanned readmissions after head and neck microvascular reconstructive surgery

Int J Oral Maxillofac Surg. 2020 Dec;49(12):1559-1565. doi: 10.1016/j.ijom.2020.04.017. Epub 2020 May 29.

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.

Keywords: complications; healthcare system; microvascular surgery; quality metric; readmissions; rehospitalizations.

MeSH terms

  • Head and Neck Neoplasms* / surgery
  • Humans
  • Patient Readmission
  • Plastic Surgery Procedures*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Risk Factors