Readmission within 30 days of discharge (ReAd): a quality-of-care indicator in paediatric surgery

Mears, Alice; Bisharat, May; Murphy, Feilim; Sinha, Chandni

doi:10.1007/s00383-019-04449-6

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…In the present study, the readmission rate was obtained from the databases provided by the insurers; therefore, if a patient was readmitted to a different hospital than the one where the appendectomy was performed, the occurrence of readmission was still registered. The readmission rate in the present study was 1.5%, which is lower than the rates reported in the medical literature, which range between 3.4 and 5.4% [10, 11, 28]. Additionally, as reported in the literature, the readmission rate was higher for younger children than for older children, and it was higher for those with an appendectomy with peritoneal drainage than for those without [11].…”

Section: Discussioncontrasting

confidence: 63%

“…Perforated appendicitis and secondary peritonitis in children are associated with a high number of complications, a high frequency of ICU use, a long LOS, a high ICU intensive care unit readmission rate and a high mortality rate [3,10,11,[18][19][20]. Peritonitis due to appendicitis occurs when a surgery is performed late, and its incidence ranges from 15 to 50% [4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Perforated appendicitis is associated with a high likelihood of complications [4][5][6][7][8] and the need for treatment in intensive care units (ICUs) [3]. A longer length of stay (LOS) due to a perforated appendix or the presence of comorbidities, the need for treatment in an ICU or hospital readmission, and treatment for complications increase the cost of treating children with appendicitis [3,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors Associated with Clinical and Economic Outcomes of Appendectomies in Children: A Multilevel Analysis in a National Retrospective Cohort Study

et al. 2019

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Background Acute appendicitis is the most common acute surgical abdominal pathology in children, and it has a large impact on morbidity and the costs incurred by health care systems. In low‐ and median‐income countries, national information on the clinical and economic outcomes associated with this surgery does not exist. This study aimed to identify and describe the clinical and economic outcomes for children undergoing appendectomy in Colombia's contributory system and to determine the prognostic factors associated with these outcomes. Methods A retrospective cohort study was conducted using administrative data from patients under 18 years of age who underwent an appendectomy between July 1, 2013, and September 30, 2015, in Colombia's contributory health system. Thirty‐day mortality rates, intensive care unit (ICU) admission rates, length of stay (LOS), readmission rates and median costs were estimated for the entire country by geographic region and insurer. The prognostic factors associated with these outcomes were identified using generalized multilevel mixed models. Results A total of 21,674 children were included. The 30‐day postoperative mortality rate was 0.06% [95% CI 0.02–0.9], the ICU admission rate was 8.00% [95% CI 7.63–8.36], the mean LOS was 2.48 days (SD 5.24), the readmission rate was 1.5% [95% CI 1.33–1.66] and the median cost for Colombia was 394 USD [p25–p75: 256–555]. The prognostic factors that were associated with the 30‐day ICU admission rate, LOS and readmission rate were the insurer, geographic region, age, occurrence of an appendectomy with peritoneal drainage, and certain comorbidities, such as cancer and neurological, respiratory and gastrointestinal illnesses. The prognostic factors associated with costs were those previously mentioned as well as the occurrence of a laparoscopic appendectomy. Conclusions In Colombia's contributory health system, large differences in clinical outcomes and the costs incurred by the system exist, and these differences are associated with the geographic region, the insurer, and some of the clinical characteristics of the children undergoing appendectomy.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors Associated with Clinical and Economic Outcomes of Appendectomies in Children: A Multilevel Analysis in a National Retrospective Cohort Study

et al. 2019

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“…The 30DRR is a recognised indicator of the quality of care and indirectly estimates the complication rate. Published studies have shown that the 30DRR varies by surgery type: 0.9%–2.0% after paediatric surgery (Mears et al., 2019), 1.1% after day surgery (Mezei & Chung, 1999), and 6.1% after spinal surgery (Khanna et al., 2015). There is little data on the 30DRR after ophthalmic surgery.…”

Section: Discussionmentioning

confidence: 99%

Unplanned 30‐day readmission rate after ophthalmological surgery as a quality‐of‐care indicator

Crozet,

Leclere,

Martin

et al. 2024

Acta Ophthalmologica

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BackgroundThe 30‐day readmission rate provides a standardised quantitative evaluation of some postoperative complications. It is widely used worldwide in many medical and surgical specialities, and the World Health Organization recommends its use for monitoring healthcare system performance. In ophthalmology, its measurement is biased by the frequent and close planned surgery on one eye and then the other, particularly in the case of cataract surgery. This study measures the 30‐day unplanned readmission rate in ophthalmology, globally and by surgery subtype, and describes the causes of readmission.MethodsAll patients readmitted within 30 days of ophthalmic surgery at Nantes University Hospital between January 2017 and December 2020 were identified in the Medical Information System. An ophthalmologist examined each medical record and collected the following data: the reason for readmission, comorbidities, the pathology treated, surgery type, surgery duration, the surgeon's experience, anaesthesia type, severity and readmission morbidity.ResultsFor the 8522 ophthalmic surgeries performed in the four‐year study period, 282 30‐day unplanned readmissions were identified. The overall 30‐day unplanned readmission rate was 2.07% for elective surgery, with a high variability depending on the surgery type: 0.95% for phacoemulsification, 4.95% for vitreoretinal surgery (3.42% for non‐elective vitreoretinal surgery, 5.44% for retinal detachment surgery), 5.66% for deep lamellar keratoplasty and 11.90% for trabeculectomy. The unplanned 30‐day readmission rate for ocular trauma surgery (emergency care) was 11.0%. Seven percent of all unplanned 30‐day readmissions were not associated with an ophthalmological problem.ConclusionsThis study is the first to report 30‐day unplanned readmission in ophthalmology, globally and by surgical subtype, for elective and urgent procedures. This indicator can be used longitudinally to detect an increase in risk or transversely to compare the quality of care between different public or private hospitals.

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“…Secondary outcomes of the study are the duration of surgery and anesthesia, length of hospital stay (LOS), frequency of hospital readmissions and postoperative pain rate. The frequency of unplanned return to the operating room (uROR) [26] and the number of readmissions within 30 days after the index operation (ReAd) [27] were examined and used as indicators of the quality of care.…”

Section: Outcomes Of the Studymentioning

confidence: 99%

Comparison of Percutaneous Internal Ring Suturing (PIRS) versus Open Ligation of the Patent Processus Vaginalis for the Treatment of Communicating Pediatric Hydrocele

Pogorelić,

Stanić,

Bašković

2024

Children

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Background: Although the laparoscopic approach become standard for the treatment of many surgical conditions many studies still debating whether laparoscopic surgery has significant advantages over open surgery in regards to hernia or hydrocele treatment. This study aimed to evaluate the outcomes of treatment of treatment of communicating hydrocele in pediatric patients between laparoscopic percutaneous internal ring suturing (PIRS) and open ligation of the patent processus vaginalis (PPV). Methods: The medical records of pediatric patients who underwent surgery for communicating hydrocele between 1 January 2019 and 1 January 2024 were retrospectively reviewed. The primary objective of the study is to investigate the outcomes of treatment (complications and recurrence rates) of communicating hydrocele in children between laparoscopic and open surgical approaches. Secondary outcomes of the study are the duration of surgery and anesthesia, length of hospital stay (LOS), frequency of hospital readmissions (ReAd) and unplanned return to the operating room (uROR). Results: A total of 198 children underwent surgery for a communicating hydrocele (205 repairs, as 7 cases were bilateral) and were included in the study. Of these, 87 children underwent a PIRS, while the remaining 111 cases underwent open ligation of the PPV. No recurrence of the hydrocele was observed in any of the study groups. Intraoperative complication (epigastric vein injury) was noted in two cases in both groups (2.3% vs. 1.8%, p > 0.999). A slightly higher number of postoperative complications was observed in the open group (n = 7, 6.3%) compared to the PIRS group (n = 2, 2.3%) (p = 0.190). The median duration of surgery (15 min (IQR 10, 17) vs. 21 min (IQR 15, 25); p < 0.001) and anesthesia (30 min (IQR 25, 40) vs. 40 min (IQR 35, 40); p < 0.001) were significantly lower in the PIRS group compared to open ligation of the PPV. In addition, a significantly shorter median of LOS was observed in the PIRS group compared to the open PPV group (9 h (IQR 8, 12) vs. 24 h (IQR 12, 24; p < 0.001). No cases of ReAd and uROR were observed in any of the study groups. Conclusions: PIRS is a safe and effective laparoscopic technique that can be used in the treatment of communicating hydrocele in children. PIRS showed excellent outcomes and a low incidence of complications and recurrences, comparable to traditional open surgery.

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Readmission within 30 days of discharge (ReAd): a quality-of-care indicator in paediatric surgery

Cited by 8 publications

References 13 publications

Prognostic Factors Associated with Clinical and Economic Outcomes of Appendectomies in Children: A Multilevel Analysis in a National Retrospective Cohort Study

Prognostic Factors Associated with Clinical and Economic Outcomes of Appendectomies in Children: A Multilevel Analysis in a National Retrospective Cohort Study

Unplanned 30‐day readmission rate after ophthalmological surgery as a quality‐of‐care indicator

Comparison of Percutaneous Internal Ring Suturing (PIRS) versus Open Ligation of the Patent Processus Vaginalis for the Treatment of Communicating Pediatric Hydrocele

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