PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Postoperative Complications Predict 30-Day Readmission in Geriatric General Surgery Patients.

Abstract The Affordable Care Act has placed unplanned patient readmissions under more scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate amount of complications from any kind of hospitalization, including readmissions. This study seeks to identify risk factors in this population that predispose them to an unplanned readmission within 30 days after index surgery. The National Surgical Quality Improvement Program database was used to select patients 65 years and older, who underwent general surgery procedures in 2012. Patient demographics, comorbidities, complications, and readmissions were analyzed. A Cox regression survivorship model was used for multivariate analysis. A total of 7712 patients were reviewed; 617 patients (8.0%) had an unplanned readmission within 30 days of their operation. Cox regression revealed five different independent predictors of unplanned readmission within 30 days. They are age [P = 0.009, hazard ratio (HR) = 1.016, 95% confidence interval (CI) = 1.01-1.03], American Society of Anesthesiologists Class >2 (P = 0.037, HR = 1.22, CI = 1.024-1.475), operation time (minutes) (P = 0.001, HR = 1.001, CI = 1.00-1.002), any complication (P = 0.03, HR = 1.449, CI = 1.33-1.852), and deep vein thrombosis (P = 0.03, HR = 1.87, CI = 1.31-3.85). Using Cox regression to adjust for patient length of stay, age, American Society of Anesthesiologists class, any complication, operation time, and venous thromboembolism all independently increased the rate of unplanned readmissions. Patients who suffer any complication or a venous thromboembolism postoperatively are at a particularly high risk of readmission. These patients should be targeted for increased inpatient monitoring and included in preventable readmission programs after discharge.
PMID
Related Publications

Analysis of 30-day readmission after aortoiliac and infrainguinal revascularization using the American College of Surgeons National Surgical Quality Improvement Program data set.

Unplanned Readmissions Following Outpatient Hand and Elbow Surgery.

Risk factors for 30-day hospital readmission after thyroidectomy and parathyroidectomy in the United States: An analysis of National Surgical Quality Improvement Program outcomes.

Thirty-day readmission and reoperation after surgery for spinal tumors: a National Surgical Quality Improvement Program analysis.

Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program.

Authors

Mayor MeshTerms

General Surgery

Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 28424131
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 83
IP  - 4
DP  - 2017 Apr 01
TI  - Postoperative Complications Predict 30-Day Readmission in Geriatric General
      Surgery Patients.
PG  - 365-370
AB  - The Affordable Care Act has placed unplanned patient readmissions under more
      scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate 
      amount of complications from any kind of hospitalization, including readmissions.
      This study seeks to identify risk factors in this population that predispose them
      to an unplanned readmission within 30 days after index surgery. The National
      Surgical Quality Improvement Program database was used to select patients 65
      years and older, who underwent general surgery procedures in 2012. Patient
      demographics, comorbidities, complications, and readmissions were analyzed. A Cox
      regression survivorship model was used for multivariate analysis. A total of 7712
      patients were reviewed; 617 patients (8.0%) had an unplanned readmission within
      30 days of their operation. Cox regression revealed five different independent
      predictors of unplanned readmission within 30 days. They are age [P = 0.009,
      hazard ratio (HR) = 1.016, 95% confidence interval (CI) = 1.01-1.03], American
      Society of Anesthesiologists Class >2 (P = 0.037, HR = 1.22, CI = 1.024-1.475),
      operation time (minutes) (P = 0.001, HR = 1.001, CI = 1.00-1.002), any
      complication (P = 0.03, HR = 1.449, CI = 1.33-1.852), and deep vein thrombosis (P
      = 0.03, HR = 1.87, CI = 1.31-3.85). Using Cox regression to adjust for patient
      length of stay, age, American Society of Anesthesiologists class, any
      complication, operation time, and venous thromboembolism all independently
      increased the rate of unplanned readmissions. Patients who suffer any
      complication or a venous thromboembolism postoperatively are at a particularly
      high risk of readmission. These patients should be targeted for increased
      inpatient monitoring and included in preventable readmission programs after
      discharge.
FAU - Dieterich, James D
AU  - Dieterich JD
FAU - Divino, Celia M
AU  - Divino CM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Body Mass Index
MH  - Comorbidity
MH  - Databases, Factual
MH  - Female
MH  - *General Surgery
MH  - Humans
MH  - Male
MH  - Patient Readmission/*statistics & numerical data
MH  - Postoperative Complications/*epidemiology
MH  - Risk Factors
MH  - United States/epidemiology
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
PST - ppublish
SO  - Am Surg. 2017 Apr 1;83(4):365-370.

<?xml version="1.0" encoding="UTF-8"?>
<b:Sources SelectedStyle="" xmlns:b="http://schemas.openxmlformats.org/officeDocument/2006/bibliography"  xmlns="http://schemas.openxmlformats.org/officeDocument/2006/bibliography" >
</b:Sources>