Predictors of Readmission after Inpatient Plastic Surgery.
10.5999/aps.2014.41.2.116
- Author:
Umang JAIN
1
;
Christopher SALGADO
;
Lauren MIOTON
;
Aksharananda RAMBACHAN
;
John Y S KIM
Author Information
1. Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg, School of Medicine, Chicago, IL, USA. jokim@nmh.org
- Publication Type:Original Article
- Keywords:
Inpatients;
Surgery, plastic;
Patient readmission
- MeSH:
Dataset;
Hemorrhage;
Humans;
Hypertension;
Inpatients*;
Obesity;
Patient Education as Topic;
Patient Readmission;
Percutaneous Coronary Intervention;
Pulmonary Disease, Chronic Obstructive;
Quality Improvement;
Risk Factors;
Surgery, Plastic*;
Track and Field
- From:Archives of Plastic Surgery
2014;41(2):116-121
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Understanding 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. METHODS: The 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. RESULTS: A 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 > or =30) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. CONCLUSIONS: Inpatient 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.
