Predictors of unanticipated admission within 30 days of outpatient sinonasal surgery

Gengler, Isabelle; Carpentier, Lenn; Pasquesoone, X.; Chevalier, Dominique; Mortuaire, G.

doi:10.4193/rhin16.251

Cited by 11 publications

(3 citation statements)

References 17 publications

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“…Prediction of the therapeutic success is interesting for both patients as well as surgeons. Gengler et al (10) report on the predictors of an unanticipated admission after sinus surgery. Depite the low percentage of readmissions, i.e.…”

Section: Paving the Future Of Rhinosinusitis Carementioning

confidence: 99%

“…Prediction of disease development and therapeutic successes of medical and surgical treatment are interesting novel concepts. Gengler et al (10) report on the predictors of an unanticipated admission after sinus surgery. Despite the low percentage of readmissions (only 5%), anticipation of the risk and adequate scheduling may represent a significant step forward to personalized care.…”

Section: Paving the Future Of Rhinosinusitis Carementioning

confidence: 99%

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Paving the future of rhinosinusitis care

2017

Rhin

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Section: Paving the Future Of Rhinosinusitis Carementioning

confidence: 99%

Section: Paving the Future Of Rhinosinusitis Carementioning

confidence: 99%

Paving the future of rhinosinusitis care

2017

Rhin

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“…Given the high fiscal penalty of readmission, it is imperative to understand independent predictors of readmission for common procedures, such as functional endoscopic sinus surgery (FESS), within otolaryngology. Although there are studies investigating national readmission rates following ambulatory sinonasal surgery, nationwide readmission rates following inpatient FESS for CRS have yet to be characterized 16,17 . The purpose of this study is to investigate the incidence, costs, causes, and independent predictors of 30‐day readmission following inpatient functional endoscopic sinus surgery for CRS in the United States.…”

Section: Introductionmentioning

confidence: 99%

National Analysis of 30‐Day Readmission Following Inpatient Sinus Surgery for Chronic Rhinosinusitis

et al. 2020

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Objectives To characterize the incidence, causes, risk factors, and costs of 30‐day readmission after inpatient functional endoscopic sinus surgery (FESS) for patients with chronic rhinosinusitis. Study Design Retrospective cohort study. Methods The Nationwide Readmissions Database was used to characterize readmission after inpatient sinus surgery for chronic rhinosinusitis from 2015 to 2017. International Classification of Disease codes were used to identify the patient population, which included 5,644 patients. Incidence, causes, costs, and predictors of readmission were analyzed and determined. Results Among 6,386 patients who underwent inpatient FESS, 742 (11.6%) were readmitted within 30 days of discharge. On univariate analysis, patients who were readmitted were more commonly older than 70 years (23.3% vs. 16.2%); had a higher burden of comorbidities including chronic kidney disease (15.0% vs. 7.8%), diabetes (25.6% vs. 20.4%), and hypertension (13.5% vs. 8.5%); had a greater rate of postoperative complications (20.7% vs. 12.2%); and had a longer length of stay (12.4 vs. 6.9 days) compared to patients who were not readmitted. Readmissions cost an additional $27,141 per patient. On multivariable analysis, age greater than 70 years, Medicaid insurance, several comorbidities, prolonged length of stay, postoperative neurologic complications, and lower hospital volume were independent predictors of 30‐day readmission. The most common cause for readmission was infection (36.3%). Conclusion Readmission following inpatient FESS is not uncommon. Identification and management of preoperative comorbidities, optimized patient selection for inpatient surgery, and thorough postoperative discharge care may improve patient outcomes and decrease healthcare expenditures. Level of Evidence 3 Laryngoscope, 131:E1422–E1428, 2021

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Factors Associated With Unanticipated Admission After Outpatient Endoscopic Sinonasal Surgery

et al. 2021

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Objectives/Hypothesis: To identify factors that may increase the risk of unplanned admission following elective outpatient endoscopic sinonasal surgery (ESS).Study Design: Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP).Methods: All cases of ESS were extracted from the 2010 to 2018 NSQIP database using Current Procedural Terminology codes. Only cases coded as outpatient, elective, and nonemergent procedures were included. Unplanned admissions were defined as cases with a total hospital stay of 1 day or more. Univariate and multivariate analyses were performed to identify variables that independently predicted unanticipated admission.Results: A total of 971 cases met inclusion criteria, of which 274 (28.2%) were unanticipated admissions. Patients in the unplanned admission group were more likely to be older (46.8 vs. 41.1 years, P < .001), male (57.7% vs. 48.4%, P = .009), obese (54.8% vs. 43.8%, P = .003), and have hypertension (35.0% vs. 25.0%, P = .002). Unplanned admitted patients were also more likely to be included under American Society of Anesthesiologists (ASA) classification III-IV (43.1% vs. 27.2%, P < .001). There were no significant differences in race, smoking, diabetes, or chronic steroid use. Unplanned admitted patients had a higher rate of surgical complications (2.9% vs. 1.0%, P = .041). Upon multivariate analysis, independent preoperative risk factors for unplanned admission included age (OR: 1.018, P = .002), male gender (OR: 1.415, P = .025), obesity (OR: 1.527, P = .008), and ASA III-IV (OR 1.501, P = .018).Conclusions: Factors independently associated with unplanned admission following outpatient ESS were older age, male gender, obesity, and higher ASA. Identification of patients at risk may reduce unanticipated hospital admission after ESS.

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Predictors of unanticipated admission within 30 days of outpatient sinonasal surgery

Abstract: Careful scheduling of those higher-risk patients undergoing sinonasal surgery and appropriate postoperative observation should be implemented to improve healthcare quality in an outpatient setting.

Cited by 11 publications

References 17 publications

Paving the future of rhinosinusitis care

Paving the future of rhinosinusitis care

National Analysis of 30‐Day Readmission Following Inpatient Sinus Surgery for Chronic Rhinosinusitis

Factors Associated With Unanticipated Admission After Outpatient Endoscopic Sinonasal Surgery

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