RT Journal Article
SR Electronic
T1 Unplanned early hospital readmissions in a vascular surgery population
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 412
OP 417
DO 10.1503/cjs.010318
VO 62
IS 6
A1 Alexandra Papadopoulos
A1 Sue Devries
A1 Janice Montbriand
A1 Naomi Eisenberg
A1 Charles de Mestral
A1 Graham Roche-Nagle
YR 2019
UL http://canjsurg.ca/content/62/6/412.abstract
AB Background: Patients who undergo vascular surgery are burdened by high early readmission rates. We examined the frequency and cause of early readmissions after elective and emergent admission to the vascular surgery service at our institution to identify modifiable targets for quality improvement.Methods: Over a 5-year period, all patients admitted and readmitted to the vascular surgery service were identified. Medical records were then individually reviewed to identify baseline characteristics from the index admission and the most responsible diagnosis for readmission within 28 days of discharge.Results: Of a total of 3324 patients, 421 (12.7%) were readmitted to our institution within 28 days of discharge. Forty-seven were found to have more than 1 readmission following their index admission. The readmission rate ranged from 11.8% to 14.1% over the 5-year study period, resulting in an average readmission rate of 12.7%. There were similar rates for men (12.9%) and women (12.3%). Of the readmitted cases, 236 (63.1%) were unplanned readmissions. The most common diagnoses for unplanned readmissions were worsening of peripheral arterial disease status including complications related to peripheral bypass graft (30.9%), surgical site infections (15.3%) and nonsurgical infections (14.8%).Conclusion: To reduce readmission rates effectively, institutions must identify high-risk patients. In our study cohort, the most frequent pathology resulting in readmission was peripheral arterial disease. The most frequent preventable reason for readmission was surgical site infection. Interventions focused on early assessment of clinical status and wounds in addition to avoidance of infectious complications could help reduce readmission rates. Preventive resources can be efficiently targeted by focusing on subgroups at risk for readmission.