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Predictors, costs, and causes of readmission after surgery for sinonasal cancer: a national perspective

2018; Wiley; Volume: 8; Issue: 9 Linguagem: Inglês

10.1002/alr.22134

2042-6984

Alexander N. Goel, Jason J. Yang, Marilene B. Wang, Jivianne T. Lee, Maie A. St. John, Jennifer L. Long,

Vascular Anomalies and Treatments

Background Hospital readmissions are an increasingly scrutinized marker of surgical care delivery and quality. There is a paucity of information in the literature regarding the rate, risk factors, and common causes of readmission after surgery for sinonasal cancer. Methods We analyzed the Nationwide Readmissions Database for patients who underwent surgery for a diagnosis of sinonasal cancer between 2010 and 2014. Rates, causes, and patient‐, procedure‐, and hospital‐level risk factors for 30‐day readmission were determined. Multivariate logistic regression was used to identify predictors of 30‐day readmission. Results Among the 4173 cases, the 30‐day readmission rate was 11.6%, with an average cost per readmission of $18,403. The most common readmission diagnoses were wound complications (15.3%) and infections (13.4%). On multivariate regression, significant risk factors for readmission were chronic renal failure (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.41‐6.17), involvement of the skull base or orbit (OR, 1.67; 95% CI, 1.11‐2.51), nonelective initial surgical admission (OR, 2.35; 95% CI, 1.42‐3.89), and length of stay ≥7 days (OR, 1.87; 95% CI, 1.14‐3.05). Conclusion Through the use of a large national database, we found that approximately 1 in 9 patients undergoing surgery for sinonasal cancer was readmitted within 30 days. Readmissions were most commonly associated with wound complications and infections. Factors related to procedural complexity were more important predictors of readmission than patients’ demographics or comorbidities.