1. Calculating surgical readmission rates in gynecologic oncology: The impact of patient factors.
- Author
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Morell, Alexandra, Samborski, Alexandra, Williams, Devin, Anderson, Elizabeth, Kittel, Julie, Thevenet-Morrison, Kelly, and Wilbur, MaryAnn
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GYNECOLOGIC oncology , *PATIENT readmissions , *GYNECOLOGIC surgery , *CANCER patients , *GYNECOLOGIC care , *SURGICAL site infections , *HOSPITAL admission & discharge - Abstract
To determine the 30-day surgical readmission rate after major gynecologic oncology surgeries at a high-volume academic institution and correlated risk factors. Retrospective cohort study was conducted of surgical admissions from January 2016 – December 2019 at a single institution. Data were extracted from patient charts, including reason for readmission and length of stay. A readmission rate was calculated. Nested case control design was used to identify correlations between readmission and patient specific risk-factors. Multivariable logistic regression models were used to determine risk factors with readmission. A total of 2152 patients were included. The readmission rate was 3.5%, most commonly due to GI disturbance and surgical site infection. Average readmission length was 5 days. Prior to adjusting for covariates, insurance status, primary diagnosis, index admission length, and disposition at discharge differed between patients who were and were not readmitted. After adjusting for co-variates, younger patients, index admission >2 days, and higher Charlson co-morbidity index were associated with readmission. Our surgical readmission rate was lower than previously reported rates in gynecologic oncology patients. Patient factors associated with readmission included younger age, longer index hospital admission, and higher medical co-morbidity index scores. Provider factors and institutional practice patterns could contribute to the decreased readmission rate. These findings underscore the importance of standardizing how we calculate readmission rate and interpret these data. Varying readmission rates and institutional practice patterns deserve closer scrutiny to inform best practice and future policies. • Postoperative readmission rate after major gynecologic oncology surgery was 3.5%; lower than previously reported rates. • Readmission cause was most commonly gastrointestinal complication and surgical site infection. • Younger age, longer index hospital admission, and higher medical co-morbidity index were associated with readmission. • Provider practice patterns warrant further study regarding contribution to readmission rate. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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