30-day readmission after pediatric upper extremity surgery: Analysis of the NSQIP database

Thibaudeau, Stéphanie; Anari, Jason B.; Carducci, Nicholas M.; Carrigan, Robert B.

doi:10.1016/j.jpedsurg.2016.04.012

Cited by 17 publications

(19 citation statements)

References 23 publications

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“…Further supporting this idea is the fact that 48.8% of our readmissions was unrelated to the principal operation (Tables S5 and S6). However, upon multivariable analysis, we found that patients with a postoperative complication during their index surgical admission were ultimately at a greater risk for readmission, also echoing prior studies . Of those patients readmitted for wound complications, 70.59% had a postoperative wound complication during their original admission.…”

Section: Discussionsupporting

confidence: 80%

“…Another important finding of the current investigation was the detection of wound and pulmonary complications as independent factors associated with unanticipated readmissions in this patient population. Our readmission rate of 0.6% is on the lower end of that reported in the pediatric literature (0.3%‐19.4%), likely secondary to the low‐risk nature of the examined procedures. Univariable analysis showed ASA classification and specific comorbidities were significant contributors to readmission (Table S4).…”

Section: Discussionmentioning

confidence: 48%

“…However, data for pediatric, elective skin, and soft tissue surgery, namely excision of benign lesions, do not exist. Prior studies evaluating perioperative outcomes following similar surgeries (tonsillectomy, polydactyly, and upper extremity fracture reduction) have found complication and readmission rates of 0.7%‐7.8% and 0.3%‐2.8%, respectively . Given that excisions of benign lesions have less surgical trespass (eg, no bony trauma (polydactyly and fracture surgery) or transection of highly vascular planes (tonsillectomy)), a lower complication rate might be expected.…”

Section: Introductionmentioning

confidence: 99%

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Predictive factors for adverse outcomes in pediatric patients undergoing low‐risk skin and soft tissue surgery: A database analysis of 6730 patients

Cheon

Longhini

Lee

et al. 2018

Pediatric Anesthesia

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Summary Background There is a paucity of data regarding risk stratification of pediatric patients presenting for low‐risk skin and soft tissue surgery. Aims We sought to determine the incidence and independent predictors of postoperative complications and unplanned 30‐day readmission in a cohort of children undergoing low‐risk skin and soft tissue surgery. Methods The study included pediatric patients who underwent minor procedures of the skin and soft tissue at continuously enrolled American College of Surgeons National Surgical Quality Improvement Program Pediatric hospitals over a two‐year period. The primary outcome was a 30‐day postoperative complication composite. The secondary outcome was unplanned 30‐day readmission. Results The final analysis included 6,730 patients. There were a total of 170 postoperative complications among 152 patients (2.23%) with the majority of complications being either wound‐related or postoperative mechanical ventilation. The independent predictors for an increased risk of postoperative complication were American Society of Anesthesiologists classification ≥3 and nutritional deficiency. There were 41 unplanned readmissions (0.61%). The presence of a postoperative wound complication or a postoperative pulmonary complication during the index hospital stay was an independent risk factor for unplanned 30‐day readmission. Conclusion Pediatric patients with American Society of Anesthesiologists classification ≥3 and nutritional deficiency undergoing low‐risk surgery are at risk for the development of postoperative complications. Patients who develop wound and postoperative pulmonary complications are at higher risk for unplanned 30‐day readmission. Identification of these higher risk patients may allow the anesthesiologist to implement targeted therapies to minimize the likelihood of occurrence of these complications.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 99%

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Predictive factors for adverse outcomes in pediatric patients undergoing low‐risk skin and soft tissue surgery: A database analysis of 6730 patients

Cheon

Longhini

Lee

et al. 2018

Pediatric Anesthesia

View full text Add to dashboard Cite

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“…Despite the definitional differences, certain past orthopaedic data set studies relied on the nebulous ''inpatient''/ ''outpatient'' NSQIP variable in their analysis as opposed to LOS[0/LOS = 0 [32,35,41,50]. When a comparison was done using admission status as a predictor of adverse events after THA, an ''inpatient'' assignment in comparison to an ''outpatient'' assignment was found to be associated with an increased risk of any adverse event, SAE, and readmission (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies in different surgical subspecialties have used this variable to compare short-term outcomes of inpatient versus outpatient surgery [19-22, 27, 28, 33, 34, 36, 39, 42-46]. Multiple recent studies in orthopaedics have used these variables to study outpatient procedures or have included these variables in their studies as well [32,35,41,50]. However, in NSQIP, the ''inpatient'' or ''outpatient'' variable is distinct from the hospital length of stay (LOS) variable [1].…”

Section: Introductionmentioning

confidence: 99%

Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes

Bovonratwet

Webb

Ondeck

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Investigating readmission rates for patients undergoing oncologic resection and endoprosthetic reconstruction for primary sarcomas and tumors involving bone

Lazarides

Flamant

Cullen

et al. 2022

Journal of Surgical Oncology

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Background: Little is known about the drivers of readmission in patients undergoing Orthopaedic oncologic resection. The goal of this study was to identify factors independently associated with 90-day readmission for patients undergoing oncologic resection and subsequent prosthetic reconstruction for primary tumors involving bone.Methods: This was a retrospective comparative cohort study of patients treated from 2008 to 2019 who underwent endoprosthetic reconstruction for a primary bone tumor or soft tissue tumor involving bone, as well as those who underwent a revision endoprosthetic reconstruction if the primary endoprosthetic reconstruction was performed for an oncologic resection. The primary outcome measure was unplanned 90-day readmission.Results: A total of 149 patients were identified who underwent 191 surgeries were for a primary bone or soft tissue tumor. The 90-day readmission rate was 28.3%. Female gender, depression, higher tumor grade, vascular reconstruction, longer procedure duration, longer length of stay (LOS), multiple surgeries during an admission and disposition to a Skilled Nursing Facility were associated with readmission (p < 0.05). In a multivariate analysis, female sex, higher tumor grade and longer procedure duration were independently associated with risk of readmission (p < 0.05).Conclusions: Readmission rates are high following endoprosthetic reconstruction for Orthopaedic oncologic resections. Further work is necessary to help minimize unplanned readmissions.

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30-day readmission after pediatric upper extremity surgery: Analysis of the NSQIP database

Cited by 17 publications

References 23 publications

Predictive factors for adverse outcomes in pediatric patients undergoing low‐risk skin and soft tissue surgery: A database analysis of 6730 patients

Predictive factors for adverse outcomes in pediatric patients undergoing low‐risk skin and soft tissue surgery: A database analysis of 6730 patients

Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes

Investigating readmission rates for patients undergoing oncologic resection and endoprosthetic reconstruction for primary sarcomas and tumors involving bone

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