Factors Associated With 90-day Readmissions Following Plastic Surgery
Farah Sayegh, MD, Andrew Warburton, Paymon Sanati-Mehrizy, MD, Nikki Burish, MD, Peter J. Taub, MD MS.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Previous studies have characterized factors associated with readmission following common plastic surgery procedures within 30 days postoperatively. The National Readmission Database (NRD) is a powerful tool to look beyond the current literature at 90-day readmission rates.
The 2010-2014 NRD was queried for the patients undergoing breast reduction, breast augmentation, mastopexy, breast reconstruction and abdominoplasty/panniculectomy. The authors identified patients undergoing these plastic surgery procedures who had readmissions within 30 days and 90 days postoperatively. The authors used univariate and multivariate logistic regression models to identify predictors of readmission within the two timeframes.
The authors identified 25,215 patients undergoing plastic surgery procedures. The overall 30-day readmission rate was 5.7% (n=1435) and the overall 90-day readmission rate was 9.7% (n=2457). Medical comorbidities that were found to be statistically significant (p<0.05) in their association with 90-day readmission include anemia deficiency, congestive heart failure, coagulopathy, depression, diabetes, obesity, and hypertension. On multivariate regression analysis of independent predictors of 90 day readmissions, patients that live in fringe counties of metro areas of ≥1 million population (OR=0.82, p<0.05), counties in metro areas of 250,000-999,999 population (OR=0.79, p<0.05), and counties in metro areas of 50,000-249,000 population (OR=0.61, p<0.05) were less likely to have septicemia-related readmissions.
The readmission rate for 90 vs. 30-day readmission increased by 4 percentage points. This suggests that current literature defining risk factors for post-operative readmission does not adequately capture post-operative readmissions.
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