Predictors of Readmission after Inpatient Plastic Surgery

Abstract

BackgroundUnderstanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery.MethodsThe 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission.ResultsA total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12-3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ≥30) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission.ConclusionsInpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

Unplanned Emergency Department Visits within 30 Days of Mastectomy and Breast Reconstruction

“…The importance of measuring readmission rates following various surgical procedures as a means to assess quality of care is well-recognized. 6,12,20–25 Our findings highlight that additional recognition of unplanned, preventable returns to the ED is warranted.…”

Development, Validation and Deployment of a Real Time 30 Day Hospital Readmission Risk Assessment Tool in the Maine Healthcare Information Exchange

“…Previous studies addressing risk of readmission proposed risk models for specific disease cohorts including heart failure [ 9 – 13 ], acute myocardial infarction [ 13 , 14 ], and pneumonia [ 13 , 15 ], or for specific patient demographics including the elderly [ 16 ], children [ 17 ] or veterans [ 18 ]. The limitations in these models are apparent when considered across a population that includes all payers, all diseases and all demographics.…”

The Impact of Metabolic Syndrome on Patients Undergoing Breast Reduction Surgery

“…One of the risk factors for metabolic syndrome includes obesity; there is an established link between obesity and outcomes in plastic surgery. Obesity was found to be one of the significant independent risk factors for higher readmission rates in both inpatient and outpatient plastic surgery settings [13,14]. Considering the underlying pathophysiology of macromastia, it is understandable that many patients seeking breast reductions are obese.…”